KPC-producing Klebsiella pneumoniae enteric colonization acquired during intensive care unit stay: the significance of risk factors for its development and its impact on mortality

Risk of infection following colonization with carbapenem-resistant Enterobactericeae: A systematic review

“…However, in studies that reported these data 12,[14][15][16][17]20 colonization or infection with CRE significantly prolonged hospital stay, with 2 studies reporting hospitalization nearly 2-fold longer in those patients with CRE. 16,17 The overall mortality rate was 10% for all patients infected or colonized. Amongst the 3 studies that reported mortality in the subset of patients with clinical infection separate from those colonized, 12,16,17 mortality rates ranged from 30%-75%.…”

“…20 Seven reported site of infection [11][12][13][14]17,19,20 and 6 studies included data on length of stay amongst CRE cases, 12,[14][15][16][17]20 whereas only 5 included mortality data. 12,[14][15][16][17] For those studies that reported data on gender, 11,14,17,18,20 men accounted for 33%-69.6% of patients colonized or infected with CRE. One study 18 found a predominance among women.…”

“…[11][12][13][14][15][16][17][18][19][20] Characteristics of the studies meeting inclusion criteria are reported in Table 1. Among these 10 studies, 1,806 colonized patients were used in our analysis.…”

“…11,14,15,[18][19][20] Alternative methods used included inoculation of brain-heart infusion broth 14,15 and use of CHROMagar K pneumonia carbapenemase Petri dishes (CHROMagar, Paris, France) for some or all specimens. 12,16,19 The study by Cho et al 13 was unique in using nasal swabs cultured on 5% sheep's blood agar plates. One study did not specify microbiologic techniques sufficiently to allow interpretation.…”

“…One study 15 performed hospitalwide screening, whereas 4 12,18-20 performed screening on patients deemed to be at higher risk based on past acute-or long-term care admission, housing on a high-prevalence ward, or known contact with other patients infected or colonized with CRE. For the remaining studies, screening was performed at specified intervals for those patients admitted to an intensive care unit 11,13,14,16 (Table 1).…”