High levels of resistant gut bacteria tied to bloodstream infection risk
New research from Rush University and the University of Michigan shows that patients with higher levels of Klebsiella pneumonia–carbapenemase-producing K pneumoniae (KPC-Kp) within the gut microbiota had a higher risk of bloodstream infection in the long-term acute care hospital (LTACH) setting. The research is published in Clinical Infectious Diseases.
The study is based on weekly rectal swabs collected from 506 patients of an LTACH in Chicago from May of 2015 through May of 2016. The swab samples were cultured and tested for KPC-Kp.
Almost half the patients (255, or 45.4%) provided samples that were colonized with KPC-Kp, and 11 (4.3%) had KPC-Kp bacteremia. In an analysis, the researchers concluded that a relative abundance cutoff of 22% predicted KPC-Kp bacteremia with sensitivity of 73%, specificity of 72%, and relative risk of 4.2 (95% confidence interval [CI], 1.3-14.0, P = 0.01).
“Among antibiotics analyzed, only preceding carbapenem use was associated with a relative abundance of KPC-Kp ≥22% (HR [hazard ratio], 2.19; 95% CI, 1.06-4.55; P = 0.036),” the authors said.