Characteristics and outcomes ofKlebsiella pneumoniaebacteraemia in Hong Kong

Autor:	Margaret Ip, Florence F. T. Ma, Carrie K. Y. Pau, Joyce H. S. You
Rok vydání:	2015
Předmět:	Male Microbiology (medical) Pediatrics medicine.medical_specialty Klebsiella pneumoniae Bacteremia beta-Lactamases Teaching hospital Cohort Studies Risk Factors Humans Medicine Aged Retrospective Studies Aged 80 and over Cross Infection Infection Control General Immunology and Microbiology biology Adult patients business.industry Mortality rate Abdominal Infection Medical record Retrospective cohort study Mean age General Medicine Middle Aged biology.organism_classification Klebsiella Infections Community-Acquired Infections Infectious Diseases Hong Kong Female business
Zdroj:	Infectious Diseases. 47:283-288
ISSN:	2374-4243 2374-4235
DOI:	10.3109/00365548.2014.985710
Popis:	We compared clinical outcomes between patients with healthcare-associated and community-acquired Klebsiella pneumoniae bacteraemia and identified predictors associated with mortality and high treatment cost in Hong Kong.This was a retrospective cohort study of patients with K. pneumoniae bacteraemia in a teaching hospital. Adult patients with K. pneumoniae in blood cultures were included. Demographics and clinical data were retrieved from medical records.The analysis included 208 patients. The mean age was 68.6 ± 16.8 years. The Pitt bacteraemia score was 2.2 ± 2.8. In all, 54.8% cases were healthcare-associated infections. The 30-day mortality rate was 32.7%. The mortality rate of patients with healthcare-associated bacteraemia was significantly higher than for community-acquired cases (p0.001). Extended-spectrum β-lactamase (ESBL)-producing K. pneumoniae accounted for 15.4% of cases. Intra- abdominal infection was the most common infection (32.7%). Prior use of immunosuppressive agents and antimicrobial therapy were two major predisposing factors for infection. The treatment cost was USD12 282 ± 11 751 and the length of hospitalization was 9.0 ± 6.7 days. Multivariate analysis showed that liver disease (odds ratio (OR) = 3.06; 95% confidence interval (CI) = 1.38-6.78), malignancy (OR = 6.86; 95% CI = 3.25-14.48), pneumonia (OR = 5.25; 95% CI = 2.05-13.41) and Pitt score1 (OR = 2.50; 95% CI = 1.25-5.00) were associated with mortality. Malignancy (OR = 2.94; 95% CI = 1.33-6.49), Pitt score1 (OR = 4.15; 95% CI = 1.87-9.24) and age72 years (OR = 2.86; 95% CI = 1.35-5.88) were associated with high treatment cost.The 30-day mortality and treatment cost of patients with K. pneumoniae bacteraemia were high in Hong Kong. Based upon the risk factors identified, infection control and treatment algorithms for K. pneumoniae bacteraemia in patients with malignancy or liver disease are highly warranted.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4eea95c3eeb0c7a5a4b2a1e042fbfe6d https://doi.org/10.3109/00365548.2014.985710 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.