Risk Factors for Klebsiella Infections among Hospitalized Patients with Preexisting Colonization
Krishna Rao, Alieysa Patel, Yuang Sun, Jay Vornhagen, Jonathan Motyka, Abigail Collingwood, Alexandra Teodorescu, Ji Hoon Baang, Lili Zhao, Keith S. Kaye, Michael A. Bachman
Abstract
Klebsiella is a leading cause of health care-associated infections. Patients who are intestinally colonized with Klebsiella are at a significantly increased risk of subsequent infection, but only a subset of colonized patients progress to disease. Colonization offers a potential window of opportunity to intervene and prevent these infections, if the patients at greatest risk could be identified. To identify patient factors associated with infection in colonized patients, we studied 1,978 colonized patients. We found that patients with a higher burden of underlying disease in general, depression in particular, and low albumin levels in a blood test were more likely to develop infection. However, these variables did not completely predict infection, suggesting that other host and microbial factors may also be important. The clinical variables associated with infection are readily available in the medical record and could serve as the foundation for developing an integrated risk assessment of Klebsiella infection in hospitalized patients.