Siderophore production as a biomarker for Klebsiella pneumoniae strains that cause sepsis: A pilot study
Siderophore production as a biomarker for Klebsiella pneumoniae strains that cause sepsis: A pilot study
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铁载体的产生作为引起败血症的肺炎克雷伯菌菌株的生物标志物：一项初步研究
DOI：
10.1016/j.jfma.2021.06.027
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发表时间：
2022
影响因子：
3.2
通讯作者：
Shuto Taichi
中科院分区：
文献类型：
--
作者：
Namikawa Hiroki;Niki Makoto;Niki Mamiko;Oinuma Ken-Ichi;Yamada Koichi;Nakaie Kiyotaka;Tsubouchi Taishi;Tochino Yoshihiro;Takemoto Yasuhiko;Kaneko Yukihiro;Kakeya Hiroshi;Shuto Taichi
肺炎克雷伯菌败血症是临床上一种重要的疾病，具有较高的死亡率和多种已知毒力因素。然而，关于这些毒力因子与K的发生的关系的研究。肺炎菌血症引起的败血症很少见。我们的目的是调查K患者的临床变量和毒力因素。方法对76例肺炎克雷伯菌败血症患者的临床资料进行回顾性分析。2012年1月至2017年7月期间肺炎菌血症。将患者分为脓毒症组(n=25)和非脓毒症组(n=51)。评估患者的背景特征、抗菌治疗方案和预后。我们评估了与TOK相关的毒力因子的分布。肺炎，如黏液黏度、衣壳多糖和铁载体。通过测量铬天青S琼脂平板上的橙色晕带来确定铁载体的产生水平。结果男女比例和年龄没有组间差异。多变量分析表明，铁载体产量水平(p<；(0.01))是K的独立预测因子。肺炎菌血症所致败血症。此外，铁载体产量预测脓毒症的最佳界值为9.6 mm(敏感性为86%，特异性为76%，AUC为0.81)。结论铁载体产量是BYK所致脓毒症的独立预测因子。肺炎菌血症。预测脓毒症发生的铁载体生产的最佳截止点为9.6 mm。为了改善预后，患有K。肺炎菌血症所致败血症伴高铁载体产生水平应慎重处理。
Background/purposeKlebsiella pneumoniaebacteremia-induced sepsis is a clinically important condition with a high mortality rate and various known virulence factors. However, studies on the association of these virulence factors with the occurrence ofK. pneumoniaebacteremia-induced sepsis are scarce. We aimed to investigate clinical variables and virulence factors in patients withK. pneumoniaebacteremia-induced sepsis.MethodsWe retrospectively reviewed the medical records of 76 patients withK. pneumoniaebacteremia between January 2012 and July 2017. Patients were divided into sepsis (n = 25) and non-sepsis (n = 51) groups. Patient background characteristics, antimicrobial regimens, and prognosis were evaluated. We assessed the distribution of virulence factors related toK. pneumoniae,such as mucoviscosity, capsular polysaccharide, and siderophores. Siderophore production levels were determined by measuring the orange halo zone on chrome azurol S agar plate assay.ResultsThere were no intergroup differences in male-to-female ratio and age. Multivariable analysis revealed that siderophore production level (p< 0.01) was an independent predictor ofK. pneumoniaebacteremia-induced sepsis. Furthermore, the optimal cut-off point of siderophore production to predict sepsis was 9.6 mm (sensitivity, 86%; specificity, 76%; AUC, 0.81).ConclusionSiderophore production was an independent predictor of sepsis caused byK. pneumoniaebacteremia. The optimal cut-off point for siderophore production for sepsis occurrence prediction was 9.6 mm. To improve outcomes, patients withK. pneumoniaebacteremia-induced sepsis with high siderophore production levels should be managed prudently.