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Clinical Usefulness of Klebsiella Pneumoniae Carbapenemase-Producing K. Pneumoniae Genotyping: The Experience of a Single-Center Epidemic

BACKGROUND: During the last decade, the spread of Klebsiella pneumoniae-carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) has increased dramatically worldwide. In this scenario, growing interest has been addressed to genotyping of KPC-Kp strains, which emerged as an important tool for a better...

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Autores principales: Rossi, Marianna, Chatenoud, Liliane, Viganò, Egidio Franco, Peri, Anna Maria, Alagna, Laura, Bramati, Simone, Manenti, Monica, Raggi, Monica, Cavallero, Annalisa, Bisi, Luca, Leone, Sebastiano, Migliorino, Guglielmo Marco, Bandera, Alessandra, Gori, Andrea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Pathogens and Immunity 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6457170/
https://www.ncbi.nlm.nih.gov/pubmed/30993245
http://dx.doi.org/10.20411/pai.v1i2.109
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author Rossi, Marianna
Chatenoud, Liliane
Viganò, Egidio Franco
Peri, Anna Maria
Alagna, Laura
Bramati, Simone
Manenti, Monica
Raggi, Monica
Cavallero, Annalisa
Bisi, Luca
Leone, Sebastiano
Migliorino, Guglielmo Marco
Bandera, Alessandra
Gori, Andrea
author_facet Rossi, Marianna
Chatenoud, Liliane
Viganò, Egidio Franco
Peri, Anna Maria
Alagna, Laura
Bramati, Simone
Manenti, Monica
Raggi, Monica
Cavallero, Annalisa
Bisi, Luca
Leone, Sebastiano
Migliorino, Guglielmo Marco
Bandera, Alessandra
Gori, Andrea
author_sort Rossi, Marianna
collection PubMed
description BACKGROUND: During the last decade, the spread of Klebsiella pneumoniae-carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) has increased dramatically worldwide. In this scenario, growing interest has been addressed to genotyping of KPC-Kp strains, which emerged as an important tool for a better understanding of the epidemiological and clinical characteristics of the outbreaks. METHODS: We performed a retrospective cohort study on patients infected with KPC-Kp during a 28-month outbreak period (January 2010–April 2012) at San Gerardo Hospital (Monza, Italy), investigating KPC-Kp genotypes by means of repetitive element sequence-based polymerase chain reaction (Rep-PCR). RESULTS: We enrolled 97 patients infected with KPC-Kp. Rep-PCR analysis identified 5 distinct clone types, with different distribution over time. During the first 12 months of the outbreak period, only 1 clone was detected (clone A, in 47 patients), while the 4 other clones were identified over the remaining 16 months (clones C, E, and F/L in 23, 24, and 3 patients respectively). Mechanical ventilation was less frequent in patients infected with clones C/E/F/L (OR = 0.14; 95% CI: 0.05-0.37) compared to clone A, and the Charlson comorbidity index (CI) was more likely to have a score >5 in patients infected with clones C/E/F/L (OR = 7.21; 95% CI: 2.24-23.14) compared to clone A. Overall mortality was higher in patients infected with clones C/E/F/L (13/20 patients, 65%) compared to those infected with clone A (7/20, 35%). Mortality in patients infected with clones C/E/F/L remained significantly higher even after adjusting for the potential confounding effect of comorbidities (ie, CI), with a hazard ratio (HR) of 4.65 (95% CI: 1.83-11.89). CONCLUSIONS: Our results suggested a close relationship between strain genotype and clinical outcome.
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spelling pubmed-64571702019-04-16 Clinical Usefulness of Klebsiella Pneumoniae Carbapenemase-Producing K. Pneumoniae Genotyping: The Experience of a Single-Center Epidemic Rossi, Marianna Chatenoud, Liliane Viganò, Egidio Franco Peri, Anna Maria Alagna, Laura Bramati, Simone Manenti, Monica Raggi, Monica Cavallero, Annalisa Bisi, Luca Leone, Sebastiano Migliorino, Guglielmo Marco Bandera, Alessandra Gori, Andrea Pathog Immun Research Article BACKGROUND: During the last decade, the spread of Klebsiella pneumoniae-carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) has increased dramatically worldwide. In this scenario, growing interest has been addressed to genotyping of KPC-Kp strains, which emerged as an important tool for a better understanding of the epidemiological and clinical characteristics of the outbreaks. METHODS: We performed a retrospective cohort study on patients infected with KPC-Kp during a 28-month outbreak period (January 2010–April 2012) at San Gerardo Hospital (Monza, Italy), investigating KPC-Kp genotypes by means of repetitive element sequence-based polymerase chain reaction (Rep-PCR). RESULTS: We enrolled 97 patients infected with KPC-Kp. Rep-PCR analysis identified 5 distinct clone types, with different distribution over time. During the first 12 months of the outbreak period, only 1 clone was detected (clone A, in 47 patients), while the 4 other clones were identified over the remaining 16 months (clones C, E, and F/L in 23, 24, and 3 patients respectively). Mechanical ventilation was less frequent in patients infected with clones C/E/F/L (OR = 0.14; 95% CI: 0.05-0.37) compared to clone A, and the Charlson comorbidity index (CI) was more likely to have a score >5 in patients infected with clones C/E/F/L (OR = 7.21; 95% CI: 2.24-23.14) compared to clone A. Overall mortality was higher in patients infected with clones C/E/F/L (13/20 patients, 65%) compared to those infected with clone A (7/20, 35%). Mortality in patients infected with clones C/E/F/L remained significantly higher even after adjusting for the potential confounding effect of comorbidities (ie, CI), with a hazard ratio (HR) of 4.65 (95% CI: 1.83-11.89). CONCLUSIONS: Our results suggested a close relationship between strain genotype and clinical outcome. Pathogens and Immunity 2017-01-09 /pmc/articles/PMC6457170/ /pubmed/30993245 http://dx.doi.org/10.20411/pai.v1i2.109 Text en © Pathogens and Immunity 2017 This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
spellingShingle Research Article
Rossi, Marianna
Chatenoud, Liliane
Viganò, Egidio Franco
Peri, Anna Maria
Alagna, Laura
Bramati, Simone
Manenti, Monica
Raggi, Monica
Cavallero, Annalisa
Bisi, Luca
Leone, Sebastiano
Migliorino, Guglielmo Marco
Bandera, Alessandra
Gori, Andrea
Clinical Usefulness of Klebsiella Pneumoniae Carbapenemase-Producing K. Pneumoniae Genotyping: The Experience of a Single-Center Epidemic
title Clinical Usefulness of Klebsiella Pneumoniae Carbapenemase-Producing K. Pneumoniae Genotyping: The Experience of a Single-Center Epidemic
title_full Clinical Usefulness of Klebsiella Pneumoniae Carbapenemase-Producing K. Pneumoniae Genotyping: The Experience of a Single-Center Epidemic
title_fullStr Clinical Usefulness of Klebsiella Pneumoniae Carbapenemase-Producing K. Pneumoniae Genotyping: The Experience of a Single-Center Epidemic
title_full_unstemmed Clinical Usefulness of Klebsiella Pneumoniae Carbapenemase-Producing K. Pneumoniae Genotyping: The Experience of a Single-Center Epidemic
title_short Clinical Usefulness of Klebsiella Pneumoniae Carbapenemase-Producing K. Pneumoniae Genotyping: The Experience of a Single-Center Epidemic
title_sort clinical usefulness of klebsiella pneumoniae carbapenemase-producing k. pneumoniae genotyping: the experience of a single-center epidemic
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6457170/
https://www.ncbi.nlm.nih.gov/pubmed/30993245
http://dx.doi.org/10.20411/pai.v1i2.109
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