Hidden reservoirs of hospital-associated infections
Claire GorrieMicrobiology Australia 38(3) 140-142 https://doi.org/10.1071/MA17051
Published: 17 August 2017
Abstract
Klebsiella pneumoniae (Kp) is a Gram-negative bacterium that is ubiquitous in the environment and is of increasing concern in public health. Kp can be carried asymptomatically as a commensal organism and can cause opportunistic infections in susceptible individuals; this is further complicated by an increasing incidence of multi-drug-resistant (MDR) strains. Given Kp can be carried asymptomatically, and can cause infections, it is possible that asymptomatic carriage acts as a reservoir for infection. Our recent work in Melbourne confirms this is often true. Individuals who tested positive for carriage of Kp, on admission to ICU, were over five times more likely to develop an infection during their hospital stay, compared to non-carriers. Whole genome sequence analyses revealed extensive diversity amongst the Kp infection-causing strains. These results indicate the majority of opportunistic infections are caused by patients' own microbiome strains that are already present on ICU admission. As such, screening of individuals on admission may enable clinicians to identify who is most at risk of developing infections during their hospital stay, and who is harboring drug-resistant strains that could transmit to others.
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