Risk Factors for Klebsiella Infections among Hospitalized Patients with Preexisting Colonization
dc.contributor.author | Rao, K | |
dc.contributor.author | Patel, A | |
dc.contributor.author | Sun, Y | |
dc.contributor.author | Vornhagen, J | |
dc.contributor.author | Motyka, J | |
dc.contributor.author | Collingwood, A | |
dc.contributor.author | Teodorescu, A | |
dc.contributor.author | Baang, JH | |
dc.contributor.author | Zhao, L | |
dc.contributor.author | Kaye, KS | |
dc.contributor.author | Bachman, MA | |
dc.contributor.editor | D’Orazio, Sarah EF | |
dc.coverage.spatial | United States | |
dc.date.accessioned | 2022-08-26T19:22:39Z | |
dc.date.available | 2022-08-26T19:22:39Z | |
dc.date.issued | 2021-05-01 | |
dc.identifier.issn | 2379-5042 | |
dc.identifier.issn | 2379-5042 | |
dc.identifier.uri | https://www.ncbi.nlm.nih.gov/pubmed/34160237 | |
dc.identifier.uri | https://hdl.handle.net/2027.42/174137 | en |
dc.description.abstract | Klebsiella commonly colonizes the intestinal tract of hospitalized patients and is a leading cause of health care-associated infections. Colonization is associated with subsequent infection, but the factors determining this progression are unclear. A cohort study was performed, in which intensive care and hematology/oncology patients with Klebsiella colonization based on rectal swab culture were enrolled and monitored for infection for 90 days after a positive swab. Electronic medical records were analyzed for patient factors associated with subsequent infection, and variables of potential significance in a bivariable analysis were used to build a final multivariable model. Concordance between colonizing and infecting isolates was assessed by wzi capsular gene sequencing. Among 2,087 hospitalizations from 1,978 colonized patients, 90 cases of infection (4.3%) were identified. The mean time to infection was 20.6 6 24.69 (range, 0 to 91; median, 11.5) days. Of 86 typed cases, 68 unique wzi types were identified, and 69 cases (80.2%) were colonized with an isolate of the same type prior to infection. Based on multivariable modeling, overall comorbidities, depression, and low albumin levels at the time of rectal swab collection were independently associated with subsequent Klebsiella infection (i.e., cases). Despite the high diversity of colonizing strains of Klebsiella, there is high concordance with subsequent infecting isolates, and progression to infection is relatively quick. Readily accessible data from the medical record could be used by clinicians to identify colonized patients at an increased risk of subsequent Klebsiella infection. | |
dc.format.medium | Print-Electronic | |
dc.language | eng | |
dc.publisher | American Society for Microbiology | |
dc.relation.haspart | ARTN e00500-21 | |
dc.rights | Licence for published version: Creative Commons Attribution 4.0 International | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
dc.subject | Klebsiella | |
dc.subject | cohort study | |
dc.subject | infection risk | |
dc.subject | intestinal colonization | |
dc.subject | multivariable model | |
dc.subject | Adult | |
dc.subject | Aged | |
dc.subject | Aged, 80 and over | |
dc.subject | Cohort Studies | |
dc.subject | Comorbidity | |
dc.subject | Depression | |
dc.subject | Female | |
dc.subject | Hematologic Neoplasms | |
dc.subject | Humans | |
dc.subject | Intensive Care Units | |
dc.subject | Klebsiella Infections | |
dc.subject | Klebsiella pneumoniae | |
dc.subject | Male | |
dc.subject | Middle Aged | |
dc.subject | Rectum | |
dc.subject | Risk Factors | |
dc.title | Risk Factors for Klebsiella Infections among Hospitalized Patients with Preexisting Colonization | |
dc.type | Article | |
dc.identifier.pmid | 34160237 | |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/174137/2/Risk Factors for Klebsiella Infections among Hospitalized Patients with Preexisting Colonization.pdf | |
dc.identifier.doi | 10.1128/mSphere.00132-21 | |
dc.identifier.doi | https://dx.doi.org/10.7302/5868 | |
dc.identifier.source | mSphere | |
dc.description.version | Published version | |
dc.date.updated | 2022-08-26T19:22:37Z | |
dc.identifier.orcid | 0000-0002-9213-7850 | |
dc.identifier.orcid | 0000-0002-5925-4289 | |
dc.identifier.orcid | 0000-0003-2051-1732 | |
dc.identifier.orcid | 0000-0003-2507-6987 | |
dc.description.filedescription | Description of Risk Factors for Klebsiella Infections among Hospitalized Patients with Preexisting Colonization.pdf : Accepted version | |
dc.identifier.volume | 6 | |
dc.identifier.issue | 3 | |
dc.identifier.startpage | e0013221 | |
dc.identifier.name-orcid | Rao, K; 0000-0002-9213-7850 | |
dc.identifier.name-orcid | Patel, A | |
dc.identifier.name-orcid | Sun, Y | |
dc.identifier.name-orcid | Vornhagen, J | |
dc.identifier.name-orcid | Motyka, J | |
dc.identifier.name-orcid | Collingwood, A | |
dc.identifier.name-orcid | Teodorescu, A | |
dc.identifier.name-orcid | Baang, JH; 0000-0002-5925-4289 | |
dc.identifier.name-orcid | Zhao, L | |
dc.identifier.name-orcid | Kaye, KS; 0000-0003-2051-1732 | |
dc.identifier.name-orcid | Bachman, MA; 0000-0003-2507-6987 | |
dc.working.doi | 10.7302/5868 | en |
dc.owningcollname | Internal Medicine, Department of |
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