PMID- 25008195
OWN - NLM
STAT- MEDLINE
DCOM- 20150520
LR  - 20211021
IS  - 1439-0973 (Electronic)
IS  - 0300-8126 (Linking)
VI  - 42
IP  - 5
DP  - 2014 Oct
TI  - The role of colonization pressure in the dissemination of colistin or tigecycline 
      resistant KPC-producing Klebsiella pneumoniae in critically ill patients.
PG  - 883-90
LID - 10.1007/s15010-014-0653-x [doi]
AB  - PURPOSE: To identify the risk factors for incident enteric colonization by 
      KPC-producing Klebsiella pneumoniae (KPC-Kp) resistant to colistin or tigecycline 
      during Intensive Care Unit (ICU) stay. METHOD: A prospective observational study 
      of patients admitted to the ICU was conducted during a 27-month period. Rectal 
      samples taken upon admission and weekly afterwards were inoculated on selective 
      chromogenic agar. K. pneumoniae isolates were characterized by standard 
      methodology. Mean inhibitory concentration (MIC) to colistin and tigecycline were 
      determined by E-test. The presence of bla KPC gene was confirmed by PCR. RESULTS: 
      Among 254 patients, 62 (24.4%) became colonized by colistin- resistant KPC-Kp 
      during their stay. Multivariate analysis revealed that corticosteroid, colistin 
      administration and number of colonized patients in nearby beds per day were 
      significantly associated with colonization. Among 257 patients, 39 (17.9%) became 
      colonized by tigecycline resistant KPC-Kp during their stay. Risk factors 
      identified by multivariate analysis were: days at risk, obesity, number of 
      colonized patients treated in nearby beds per day and administration of 
      tigecycline. CONCLUSIONS: The high prevalence of colistin or tigecycline 
      resistant KPC-Kp enteric carriage in ICU patients indicate that dissemination is 
      due to their transfer from patient to patient via the personnel and indicates the 
      importance of strict infection control protocols.
FAU - Papadimitriou-Olivgeris, M
AU  - Papadimitriou-Olivgeris M
AD  - Division of Infectious Diseases, Internal Medicine, School of Medicine, 
      University of Patras, 26504, Rion-Patras, Greece.
FAU - Christofidou, M
AU  - Christofidou M
FAU - Fligou, F
AU  - Fligou F
FAU - Bartzavali, C
AU  - Bartzavali C
FAU - Vrettos, T
AU  - Vrettos T
FAU - Filos, K S
AU  - Filos KS
FAU - Marangos, M
AU  - Marangos M
FAU - Anastassiou, E D
AU  - Anastassiou ED
LA  - eng
PT  - Journal Article
DEP - 20140710
PL  - Germany
TA  - Infection
JT  - Infection
JID - 0365307
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Bacterial Proteins)
RN  - 70JE2N95KR (Tigecycline)
RN  - EC 3.5.2.6 (beta-Lactamases)
RN  - EC 3.5.2.6 (carbapenemase)
RN  - FYY3R43WGO (Minocycline)
RN  - Z67X93HJG1 (Colistin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anti-Bacterial Agents/*pharmacology
MH  - Bacterial Proteins/genetics/metabolism
MH  - Colistin/*pharmacology
MH  - *Drug Resistance, Bacterial
MH  - Female
MH  - Greece/epidemiology
MH  - Hospitalization
MH  - Hospitals, University
MH  - Humans
MH  - Intensive Care Units
MH  - Klebsiella Infections/*epidemiology/microbiology/transmission
MH  - Klebsiella pneumoniae/*drug effects/enzymology
MH  - Male
MH  - Middle Aged
MH  - Minocycline/*analogs & derivatives/pharmacology
MH  - Prospective Studies
MH  - Risk Factors
MH  - Tertiary Care Centers
MH  - Tigecycline
MH  - beta-Lactamases/genetics/metabolism
EDAT- 2014/07/11 06:00
MHDA- 2015/05/21 06:00
CRDT- 2014/07/11 06:00
PHST- 2014/03/31 00:00 [received]
PHST- 2014/06/20 00:00 [accepted]
PHST- 2014/07/11 06:00 [entrez]
PHST- 2014/07/11 06:00 [pubmed]
PHST- 2015/05/21 06:00 [medline]
AID - 10.1007/s15010-014-0653-x [doi]
PST - ppublish
SO  - Infection. 2014 Oct;42(5):883-90. doi: 10.1007/s15010-014-0653-x. Epub 2014 Jul 
      10.