Clinical and virulence factors related to the 30-day mortality of Klebsiella pneumoniae bacteremia at a tertiary hospital: a case-control study
Clinical and virulence factors related to the 30-day mortality of Klebsiella pneumoniae bacteremia at a tertiary hospital: a case-control study
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DOI：
10.1007/s10096-019-03676-y
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发表时间：
2019-10-11
影响因子：
4.5
通讯作者：
Kakeya, Hiroshi
中科院分区：
文献类型：
--
作者：
Namikawa, Hiroki;Niki, Makoto;Kakeya, Hiroshi
肺炎克雷伯菌菌血症是一种严重的临床表现，与高死亡率相关。然而，很少有研究探讨与克氏杆菌死亡率相关的毒力因子。肺炎菌血症患者。本研究阐明了与克雷伯氏菌30天死亡率相关的临床和毒力因素。肺炎菌血症在三级医院。本文对129例克雷伯氏菌病患者的临床资料进行了分析。回顾性分析了2012年1月至2018年12月期间大坂市立大学医院收治的肺炎菌血症。对患者的背景特征、抗菌治疗方案和预后进行了评价。此外，使用多重聚合酶链反应评估毒力因子，以阐明它们与K。肺炎。30天死亡率为10.9%。肺炎菌血症。非幸存者和幸存者组之间的男女比例、年龄和基础疾病没有差异。多变量分析显示，脓毒症（OR，7.46; p = 0.005）和iutA（OR，4.47; p = 0.046）是与K.肺炎菌血症。尽管K.肺炎菌血症，脓毒症和肺炎克雷伯菌感染者的治疗。携带iutA的肺炎可能需要仔细管理以改善其结果。
Klebsiella pneumoniae bacteremia is a critical clinical presentation that is associated with high mortality. However, extremely few studies have investigated the virulence factors related to mortality of K. pneumoniae bacteremia in patients. The present study elucidated clinical and virulence factors associated with the 30-day mortality of K. pneumoniae bacteremia at a tertiary hospital. The medical records of 129 patients with K. pneumoniae bacteremia admitted to Osaka City University Hospital between January 2012 and December 2018 were retrospectively reviewed. Patient background characteristics, antimicrobial regimens, and prognosis were evaluated. Additionally, virulence factors were assessed using multiplex polymerase chain reaction to elucidate their association with K. pneumoniae. The 30-day mortality was 10.9% in patients with K. pneumoniae bacteremia. The male-to-female ratio, age, and underlying disease did not differ between the non-survivor and survivor groups. Multivariate analysis showed that sepsis (odds ratio (OR), 7.46; p = 0.005) and iutA (OR, 4.47; p = 0.046) were independent predictors associated with the 30-day mortality of K. pneumoniae bacteremia. Despite the relatively low 30-day mortality of patients with K. pneumoniae bacteremia, the treatment of those with sepsis and those infected with K. pneumoniae harboring iutA may require careful management for improving their outcomes.