ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019
Increased Relative Abundance of Klebsiella pneumoniae Carbapenemase-producing Klebsiella pneumoniae Within the Gut Microbiota Is Associated With Risk of Bloodstream Infection in Long-term Acute Care Hospital Patients.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 75 papers.
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Who cites it
75 citing papers in PubMed, 131 citations in OpenAlex.
- Microbiota Transplantation Among Patients Receiving Long-Term Care: The Sentinel REACT Nonrandomized Clinical Trial.JAMA network open · 2025Trial
- Role of Households with Children in Community Spread of Multidrug-Resistant Enterobacterales, St. Louis, Missouri, USA.Emerging infectious diseases · 2026Article
- The intestinal microbiota impacts nutritional immunity and resistance toProceedings of the National Academy of Sciences of the United States of America · 2026Article
- Decentralized nanopore genomics reveals diverseMicrobial genomics · 2026Article
- The bug, the burden, and the biology: beyond host-centric phenotyping in sepsis.The Journal of clinical investigation · 2026Article
- Projected impact of a pathogen reduction intervention on carbapenem-resistant Enterobacterales bloodstream infections and deaths in the United States.Infection control and hospital epidemiology · 2026Article
- Function of molecular-weight-optimized Astragalus polysaccharides in cisplatin-caused acute kidney injury: mechanisms centered on gut microbiota regulation and precise treatment approaches.Frontiers in microbiology · 2026Review
- Dysbiosis and the gut-brain axis impairment in the pathophysiology of Alzheimer's disease and related dementias: is 'pathobiome' an etiological element?Essays in biochemistry · 2025Review
- Article
- Role of the gut microbiome in frequent gut colonization with extended-spectrum β lactamase-producing Enterobacterales among Peruvian children.Gut microbes · 2025Article
- Leveraging strain competition to address antimicrobial resistance with microbiota therapies.Gut microbes · 2025Review
- Using wastewater surveillance to investigate community-level differences in antibacterial resistance in a major urban center, USA.Applied and environmental microbiology · 2025Article
- Microbiota and kidney disease: the road ahead.Nature reviews. Nephrology · 2025Review
- Gut Microbiome-Based Strategies for the Control of Carbapenem-Resistant Enterobacteriaceae.Journal of microbiology and biotechnology · 2025Review
- Protein Malnutrition Facilitates Intestinal Colonization with Highly ResistantbioRxiv : the preprint server for biology · 2025Article
- Chinese soy-based microbiome and associated microbial risks: a metagenomic investigation.NPJ biofilms and microbiomes · 2025Article
- Bloodstream infection by Lactobacillus rhamnosus in a haematology patient: why metagenomics can make the difference.Gut pathogens · 2025Article
- De novo virulence feature discovery and risk assessment in Klebsiella pneumoniae based on microbial genome vectorization.Communications biology · 2025Article
- Characterization and genome analysis of novel Klebsiella pneumoniae phage vbKpUKJ_2 isolated from hospital sewage water.BMC microbiology · 2025Article
- Risk of occult gastrointestinal bleeding with increased gutFrontiers in neuroscience · 2025Article
15 more citing papers are in PubMed but not listed here.
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Authors and funding
17 authors at 2 institutions in 3 countries.
Funding
Abstract
backgroundAn association between increased relative abundance of specific bacterial taxa in the intestinal microbiota and bacteremia has been reported in some high-risk patient populations.
methodsWe collected weekly rectal swab samples from patients at 1 long-term acute care hospital (LTACH) in Chicago from May 2015 to May 2016. Samples positive for Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) by polymerase chain reaction and culture underwent 16S rRNA gene sequence analysis; relative abundance of the operational taxonomic unit containing KPC-Kp was determined. Receiver operator characteristic (ROC) curves were constructed using results from the sample with highest relative abundance of KPC-Kp from each patient admission, excluding samples collected after KPC-Kp bacteremia. Cox regression analysis was performed to evaluate risk factors associated with time to achieve KPC-Kp relative abundance thresholds calculated by ROC curve analysis.
resultsWe collected 2319 samples from 562 admissions (506 patients); KPC-Kp colonization was detected in 255 (45.4%) admissions and KPC-Kp bacteremia in 11 (4.3%). A relative abundance cutoff of 22% predicted KPC-Kp bacteremia with sensitivity 73%, specificity 72%, and relative risk 4.2 (P = .01). In a multivariable Cox regression model adjusted for age, Charlson comorbidity index, and medical devices, carbapenem receipt was associated with achieving the 22% relative abundance threshold (P = .044).
conclusionCarbapenem receipt was associated with increased hazard for high relative abundance of KPC-Kp in the gut microbiota. Increased relative abundance of KPC-Kp was associated with KPC-Kp bacteremia. Whether bacteremia arose directly from bacterial translocation or indirectly from skin contamination followed by bloodstream invasion remains to be determined.
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