KPC-producing Klebsiella pneumoniae rectal colonization is a risk factor for mortality in patients with diabetic foot infections

Clin Microbiol Infect. 2015 Aug;21(8):790.e1-3. doi: 10.1016/j.cmi.2015.04.010. Epub 2015 Apr 22.

Abstract

To evaluate the relationship between carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) gut colonization and mortality in diabetic patients with a foot infection (DFI) we performed a single-centre, retrospective, matched case-control study. In the study period, we identified 21 patients with DFI who had KPC-Kp gut colonization and 21 controls. The 90-day mortality rate was significantly higher in patients with colonized guts (47%) than the controls (4%) (p 0.013). A multivariate analysis demonstrated that gut colonization with KPC-Kp was the only independent predictor of mortality: odds ratio 13.33, 95% CI 1.90-272.80, p 0.024. In patients with DFI, KPC-Kp gut colonization appears to be an important risk factor for mortality.

Keywords: Carbapenem resistant; Diabetic foot infections; KPC-Klebsiella pneumoniae; gut colonization; mortality.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carrier State / epidemiology
  • Carrier State / microbiology*
  • Case-Control Studies
  • Diabetic Foot / mortality*
  • Female
  • Humans
  • Klebsiella Infections / epidemiology
  • Klebsiella Infections / microbiology*
  • Klebsiella pneumoniae / enzymology*
  • Klebsiella pneumoniae / isolation & purification
  • Male
  • Risk Factors
  • Survival Analysis
  • beta-Lactamases / metabolism*

Substances

  • beta-Lactamases