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dc.contributor.authorGorrie, CL
dc.contributor.authorMirceta, M
dc.contributor.authorWick, RR
dc.contributor.authorEdwards, DJ
dc.contributor.authorThomson, NR
dc.contributor.authorStrugnell, RA
dc.contributor.authorPratt, NF
dc.contributor.authorGarlick, JS
dc.contributor.authorWatson, KM
dc.contributor.authorPilcher, DV
dc.contributor.authorMcGloughlin, SA
dc.contributor.authorSpelman, DW
dc.contributor.authorJenney, AWJ
dc.contributor.authorHolt, KE
dc.date.accessioned2021-02-03T23:56:18Z
dc.date.available2021-02-03T23:56:18Z
dc.date.issued2017-07-15
dc.identifierpii: 3084729
dc.identifier.citationGorrie, C. L., Mirceta, M., Wick, R. R., Edwards, D. J., Thomson, N. R., Strugnell, R. A., Pratt, N. F., Garlick, J. S., Watson, K. M., Pilcher, D. V., McGloughlin, S. A., Spelman, D. W., Jenney, A. W. J. & Holt, K. E. (2017). Gastrointestinal Carriage Is a Major Reservoir of Klebsiella pneumoniae Infection in Intensive Care Patients. CLINICAL INFECTIOUS DISEASES, 65 (2), pp.208-215. https://doi.org/10.1093/cid/cix270.
dc.identifier.issn1058-4838
dc.identifier.urihttp://hdl.handle.net/11343/259000
dc.description.abstractBackground: Klebsiella pneumoniae is an opportunistic pathogen and leading cause of hospital-associated infections. Intensive care unit (ICU) patients are particularly at risk. Klebsiella pneumoniae is part of the healthy human microbiome, providing a potential reservoir for infection. However, the frequency of gut colonization and its contribution to infections are not well characterized. Methods: We conducted a 1-year prospective cohort study in which 498 ICU patients were screened for rectal and throat carriage of K. pneumoniae shortly after admission. Klebsiella pneumoniae isolated from screening swabs and clinical diagnostic samples were characterized using whole genome sequencing and combined with epidemiological data to identify likely transmission events. Results: Klebsiella pneumoniae carriage frequencies were estimated at 6% (95% confidence interval [CI], 3%-8%) among ICU patients admitted direct from the community, and 19% (95% CI, 14%-51%) among those with recent healthcare contact. Gut colonization on admission was significantly associated with subsequent infection (infection risk 16% vs 3%, odds ratio [OR] = 6.9, P < .001), and genome data indicated matching carriage and infection isolates in 80% of isolate pairs. Five likely transmission chains were identified, responsible for 12% of K. pneumoniae infections in ICU. In sum, 49% of K. pneumoniae infections were caused by the patients' own unique strain, and 48% of screened patients with infections were positive for prior colonization. Conclusions: These data confirm K. pneumoniae colonization is a significant risk factor for infection in ICU, and indicate ~50% of K. pneumoniae infections result from patients' own microbiota. Screening for colonization on admission could limit risk of infection in the colonized patient and others.
dc.languageEnglish
dc.publisherOXFORD UNIV PRESS INC
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.titleGastrointestinal Carriage Is a Major Reservoir of Klebsiella pneumoniae Infection in Intensive Care Patients
dc.typeJournal Article
dc.identifier.doi10.1093/cid/cix270
melbourne.affiliation.departmentBiochemistry and Molecular Biology
melbourne.affiliation.departmentMicrobiology and Immunology
melbourne.affiliation.facultyMedicine, Dentistry & Health Sciences
melbourne.source.titleClinical Infectious Diseases
melbourne.source.volume65
melbourne.source.issue2
melbourne.source.pages208-215
melbourne.identifier.nhmrc1043822
melbourne.identifier.nhmrc1061409
dc.rights.licenseCC BY
melbourne.elementsid1196868
melbourne.contributor.authorEdwards, David
melbourne.contributor.authorWick, Ryan
melbourne.contributor.authorStrugnell, Richard
melbourne.contributor.authorHolt, Kathryn
melbourne.contributor.authorGorrie, Claire
melbourne.contributor.authorGorrie, Claire
dc.identifier.eissn1537-6591
melbourne.identifier.fundernameidNHMRC, 1043822
melbourne.identifier.fundernameidNHMRC, 1061409
melbourne.accessrightsOpen Access


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