Gastrointestinal carriage of Klebsiella pneumoniae is a risk factor of subsequent hospital acquired infection

With great interest we have read the position paper in a recent issue of the Clinical Infectious Diseases from Claire L. Gorrie and colleagues defining gastrointestinal (GI) carriage is a major reservoir of Klebsiella pneumoniae (K. pneumoniae) infection in intensive care patients (1). The results indicated the community-acquired GI carriage of K. pneumoniae was 5.9%, which was much lower than that of the hospital-acquired (HA) carriage (19%), at the ICU administration. The clinical significances of the GI K. pneumoniae carriage in ICU setting were featured as a powerful association with subsequent K. pneumoniae infections, and a direct genomic link between colonizing and infection strains. Apart from 12% infection cases resulting from nosocomial transmission, most of K. pneumoniae infections were attributable to patients’ own GI strains. Therefore, the authors conclude that the GI of Klebisell pneumonia is a significant risk factor for HA infection (1).