Colonización por Klebsiella pneumoniae productora de carbapenemasa tipo KPC en un hospital universitario

摘要

KPC-producing Klebsiella pneumoniae colonization at a University HospitalA surveillance study was conducted at a University Hospital in Buenos Aires City aimed to assess the rates of colonization with carbapenemaseproducingstrains of Klebsiella pneumoniae, which are bacteria of utmost epidemiological importance. To this end, rectal swabs collected from allinpatients were cultured for the presence of these bacteria. Two point prevalence surveys showed high prevalence rates (up to 25%). The followingvariables were evaluated in all inpatients: place of origin (home or other chronic care center), age, prolonged hospitalization, antibiotics for at least 72hours prior to swabbing, intensive care unit requirements for at least 24 hours, mechanical ventilation assistance for more than 4 days, hemodialysisrequirements, need for surgery, enteral feeding through a nasogastric tube, and functional evaluation according to the Karnofsky performance scale. Thevariable associated with the highest statistical significance was the use of nasogastric enteral feeding. Also, the length of stay was significantly higherand the functional status was significantly worse in colonized patients. As for the prior use of antibiotics, results were close to statistical significance butwithout reaching it. Measures were implemented in order to control the spread of the microorganism in the acute setting and beyond. Uponimplementation of such measures, a third prevalence survey was performed that showed a decrease in the horizontal transmission of the microorganism.