ArticleInfectious diseases and therapy2025
From Colonisation to Infection: Assessing the BSI Potential in Patients with KPC, NDM, VRE and CRAB Rectal Colonisation.
Article in Infectious diseases and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Risk factors associated with the development of multidrug-resistant bloodstream infection in patients with colonization: a case-control retrospective study.IJID regions · 2026Article
- Genomic characterization of ceftazidime/avibactam-resistant KPC-producingFrontiers in microbiology · 2026Article
- Association between MDROs colonization and subsequent infections in ICU patients: a retrospective cohort study.Frontiers in public health · 2026Article
- Functional recovery and mortality after intensive inpatient rehabilitation for severe acquired brain injury in older adults: a retrospective cohort study.Frontiers in rehabilitation sciences · 2026Article
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14 authors.
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Abstract
introductionMulti-drug-resistant organisms (MDROs) that mostly contribute to nosocomial infections include carbapenem-resistant Enterobacterales that produce Klebsiella pneumoniae carbapenemase (KPC) and New Delhi metallo-β-lactamase (NDM), carbapenem-resistant Acinetobacter baumannii (CRAB) and vancomycin-resistant Enterococcus faecium (VRE). Patients colonised by these MDROs are at high risk for developing bloodstream infections (BSIs) by the same pathogen, emphasising the need for surveillance and intervention.
methodsThis retrospective study included patients admitted to medical, surgical, and intensive care unit (ICU) wards in the IRCCS Policlinico San Matteo (Pavia, Italy) between January 2019 and October 2024 with rectal colonisation by KPC, NDM, VRE and CRAB. Demographic, clinical and microbiological data were extracted from electronic records. Logistic regression with stepwise model-building identified risk factors for BSI development.
resultsA total of 1969 patients colonised with MDRO were identified: 79% of them were colonised by KPC, VRE, CRAB or NDM. Among the 1960 hospitalisations involving these specific rectal colonisations, the overall rate of BSIs was 9.4%, with CRAB and KPC showing the highest rates (20.0% and 12.6%, respectively). ICU hospitalisation was significantly associated with an increased risk of BSI in patients colonised with KPC, NDM and VRE. Haematological malignancies and bone marrow transplantation were independent risk factors for BSI in patients colonised with KPC (odds ratio [OR] = 3.22, p = 0.037) and VRE (OR = 4.07, p = 0.004) whereas solid organ transplantation increased BSI risk among patients colonised with CRAB (OR = 11.83, p = 0.034).
conclusionsOur findings show heterogeneous BSI risk among MDROs, with CRAB and KPC being the most dangerous, especially in patients in the ICU, followed by VRE in onco-haematological cases. These results support developing prevention strategies for critically ill and immunocompromised patients.
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