AUTHOR=Pellicé Martina , Rodríguez-Núñez Olga , Rico Verónica , Agüero Daiana , Morata Laura , Cardozo Celia , Puerta-Alcalde Pedro , Garcia-Vidal Carolina , Rubio Elisa , Fernandez-Pittol Mariana J. , Vergara Andrea , Pitart Cristina , Marco Francesc , Santana Gemina , Rodríguez-Serna Laura , Vilella Ana , López Ester , Soriano Alex , Martínez Jose Antonio , Del Rio Ana 

TITLE=Factors Associated With Short-Term Eradication of Rectal Colonization by KPC-2 Producing Klebsiella pneumoniae in an Outbreak Setting

JOURNAL=Frontiers in Microbiology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2021.630826

DOI=10.3389/fmicb.2021.630826

ISSN=1664-302X

ABSTRACT=Background: KPC-producing Klebsiella pneumoniae (KPCKP) is a threat for patients admitted to healthcare institutions. In this study, we assess the efficacy of several decolonization strategies for KPCKP rectal carriage.
Methods: Observational study performed during an outbreak of KPCKP on the efficacy of a 10-day non-absorbable oral antibiotic (NAA) regimen (colistin 10 mg/L, amikacin 8 mg/mL and nystatin 30 mg/mL, 10 mL/6 h)  vs the same regimen followed by a probiotic (Vivomixx®) for 20 days.
Results: Seventy-three patients were included, 21 patients (29%) did not receive any treatment and 52 (71.2%) received NAA either alone (n=26, 35.6%) or followed by a probiotic (n=26, 35.6%). Eradication was observed in 56 (76.7%) patients. The only variable significantly associated with it was not receiving systemic antibiotics (22/24 [91.6%] vs 34/49 [69.3%], p=0.04). Eradication in patients receiving NAA plus probiotic was numerically but not significantly higher than control (23/26 [88.4%] vs 15/21 [71.4%], p=0.14) and of those receiving only NAA (OR 3.4, 95% CI 0.78-14.7, p=0.09).    
Conclusion: KPCKP colonization persisted after a mean of 36 days in only about one quarter of colonized patients. A 10-day course of NAA had no impact on eradication. Probiotics after NAA may increase the decolonization rate.