Bacteremic community-acquired pneumonia due to Klebsiella pneumoniae: clinical and microbiological characteristics in Taiwan, 2001-2008

• Published in: BMC infectious diseases 2010-10, Vol.10 (1), p.307-307, Article 307
• Main Authors: Lin, Yi-Tsung, Jeng, Yuan-Yu, Chen, Te-Li, Fung, Chang-Phone
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antibiotics; Bacteremia; Bacteremia - microbiology; Bacteremia - mortality; Bacteremia - pathology; Bacterial pneumonia; Causes of; Community-Acquired Infections - complications; Community-Acquired Infections - microbiology; Community-Acquired Infections - mortality; Community-Acquired Infections - pathology; Confidence intervals; Data collection; Distribution; Female; Genotype & phenotype; Hospitalization; Humans; Identification and classification; Klebsiella; Klebsiella Infections - complications; Klebsiella Infections - microbiology; Klebsiella Infections - mortality; Klebsiella Infections - pathology; Klebsiella pneumoniae; Klebsiella pneumoniae - isolation & purification; Male; Microbiology; Middle Aged; Mortality; Multivariate analysis; Patient outcomes; Pneumococcal Infections - complications; Pneumococcal Infections - microbiology; Pneumococcal Infections - mortality; Pneumococcal Infections - pathology; Pneumonia; Pneumonia, Bacterial - complications; Pneumonia, Bacterial - microbiology; Pneumonia, Bacterial - mortality; Pneumonia, Bacterial - pathology; Retrospective Studies; Risk Factors; Shock, Septic - mortality; Streptococcus infections; Streptococcus pneumoniae; Streptococcus pneumoniae - isolation & purification; Taiwan; Tuberculosis
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/1471-2334-10-307

Klebsiella pneumoniae is the major cause of community-acquired pyogenic infections in Taiwan. This retrospective study evaluated the clinical and microbiological characteristics of bacteremic community-acquired pneumonia due to K. pneumoniae in Taiwanese adults. The clinical characteristics of bacteremic community-acquired pneumonia (CAP) in adults due to K. pneumoniae were compared to those of adults with bacteremic CAP due to Streptococcus pneumoniae at a tertiary medical center in Taiwan from 2001-2008. Risk factors for mortality of bacteremic CAP due to K. pneumoniae were analyzed. All clinical isolates of K. pneumoniae were examined for capsular serotypes, hypermucoviscosity phenotype, aerobactin and rmpA gene. K. pneumoniae was the dominant cause of bacteremic CAP and was associated with a more fulminant course and a worse prognosis than bacteremic CAP due to Streptococcus pneumoniae. Initial presentation with septic shock and respiratory failure were independent risk factors for both early and total mortality. Serotype K1 and K2 comprised around half of all isolates. There were no significant differences in the clinical characteristics of patients with bacteremic CAP due to K1/K2 and non-K1/K2 isolates. Hypermucoviscosity phenotype as well as the aerobactin and rmpA genes were highly prevalent in the K. pneumoniae isolates. K. pneumoniae continued to be the dominant cause of bacteremic CAP in Taiwanese adults during 2001-2008. Initial presentation with septic shock and respiratory failure were independent risk factors for both early and total mortality from K. pneumoniae bacteremic CAP. Serotypes K1/K2 comprised around half of all isolates, but did not predispose patients to a poor clinical outcome. Physicians should be aware of the poor prognosis of any patient with bacteremic K. pneumoniae CAP and monitor these patients more closely.