Patients with carbapenem-resistant K. pneumoniae require more intensive and invasive care. We have shown that the crude and attributable mortality rates associated with carbapenem-resistant K. pneumoniae bacteremia were striking.

No abstract

This SDD regimen could be a suitable decolonization therapy for selected patients colonized with CRKP, such as transplant recipients or immunocompromised patients pending chemotherapy and patients who require major intestinal or oropharyngeal surgery. Moreover, in outbreaks caused by CRKP infections that are uncontrolled by routine infection control measures, SDD could provide additional infection containment.

Exposure to tobacco smoke increased S. pneumoniae carriage rates in general and for carriage of serotypes included in the conjugate 7-valent vaccine in particular in children. Smoking mothers had a higher S. pneumoniae carriage rate than did nonsmoking mothers. Smoking or exposure to smoking did not increase H. influenzae carriage rates in children and mothers.

The age, sex, and seasonal distributions of invasive Kingella kingae infections in southern Israel were examined and compared to the epidemiology of respiratory carriage of the organism. Medical records of all patients diagnosed between 1988 and 2002 were reviewed, and 2,044 oropharyngeal specimens were cultured on selective media during two periods (February to May and October to December) in 2001. Invasive infections significantly affected children (73 of 74 patients [98.6%] were younger than 4 years), 50 patients (67.8%) were males (P ‫؍‬ 0.045), and 55 episodes (74.3%) occurred between July and December (P ‫؍‬ 0.004). Carriage was higher in the 0-to 3-year-old group and decreased with increasing age (P for trend ‫؍‬ 0.0008). Carriage rates were similar in both sexes and did not significantly differ between the February-to-May and October-toDecember periods. The highest rate of carriage of K. kingae coincided with the age (less than 4 years) at which invasive infections were especially frequent. The peculiar sex and seasonal distributions of invasive disease, however, cannot be readily explained by the epidemiology of respiratory carriage. Viral infections and other yet-to-be-defined cofactors may play a role in the causation of invasive K. kingae infections.For most of the four decades that elapsed since the first characterization of Kingella kingae, this gram-negative bacterium was considered a rare cause of human disease and therefore was mostly neglected (5,8,20). In recent years, as the result of improved isolation techniques, there has been an increasing number of reports on invasive K. kingae infections in the United States, Western Europe, and Israel, suggesting that the organism is an important cause of bacteremia and septic arthritis in pediatric patients (2,4,6,7,13,14,21,22,25). Moreover, studies conducted to elucidate the natural niche of K. kingae have shown that the organism is a frequent component of the oropharyngeal flora of young children and is readily transmitted from person to person among day care center (DCC) attendees (19,24).Despite the enlarging body of information on the clinical and diagnostic aspects of K. kingae infections, the epidemiology of the organism remains largely unknown. A study was performed to investigate the sex, age, and seasonal distributions of invasive K. kingae infections and to correlate these data with the respiratory carriage of the organism. MATERIALS AND METHODSSoroka University Medical Center (SUMC) is a 950-bed university hospital located in the city of Beer-Sheva and is the only medical facility providing inpatient medical services to the entire population of southern Israel (450,000 inhabitants). The Clinical Microbiology Laboratory (CML) of SUMC provides diagnostic microbiology services to hospitalized patients and to the outpatient population of 139 community clinics in the area.Bacteriological methods. Patients referred to the emergency department or hospitalized at SUMC with a febrile illness undergo routine blood cultures with the BACTEC system (B...