{"title":"成人克雷伯氏菌肺炎菌血症的临床特点和结局","authors":"Tiong Chan Lee, Asma’ Md Arif, Nurul Huda Razali, Vicknesan Kulaisingham, Hashvina Sukesh, Voon Yaa Tay, Mohd Ashraf Ghazali, Jin Koh Ewe, Sitinah Omar, Hamizan Othman, Toh Phang Teck","doi":"10.31436/imjm.v22i4.2333","DOIUrl":null,"url":null,"abstract":"INTRODUCTION: Klebsiella pneumonia (K. pneumonia) bacteremia is one of the leading causes of hospital morbidity and mortality. Our study aimed to evaluate the clinical characteristics, risk factors and outcomes of K. pneumonia bacteremia in a Malaysian public hospital. MATERIALS AND METHODS: A retrospective cross-sectional study of adults with K. pneumonia bacteremia was conducted in a hospital in Johor, Malaysia. Demographics, medical comorbidities, source of infections and the mortality rate was reviewed and analyzed. RESULTS: A total of 185 cases of K. pneumonia bacteremia were included for analysis. The mean age for this study was 54.9 (SD 15.4), with 56.8% males and 46.5% in-hospital mortality. Extended-spectrum Beta Lactamase (ESBL) producing and Carbapenem-resistant K. pneumonia contributed to 37.3% and 1.1 % of K. pneumonia bacteremia, respectively. Among those who contracted K. pneumonia bacteremia, two most frequent sources were primary bloodstream infections (n=75, 40.5%), pneumonia (n=44, 23.8%) and urinary tract infections (n=28, 15.1%). There was statistically significant associations found between diabetes mellitus (AOR 1.46, 95% CI 1.02-2.08), cancer (AOR 2.02, 95% CI 1.33-3.05) and alcohol use disorder (AOR 7.73,95% CI 1.38-43.21 ) with K. pneumonia bacteremia. In-hospital mortality was higher in older patients by 1.03 odds (p=0.003). CONCLUSION: Diabetes mellitus, cancer, and alcohol use disorder were independent risk factors associated with K. pneumonia bacteremia. Patients with advanced age had a higher mortality rate.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.3000,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical Characteristics and Outcomes of Klebsiella Pneumonia Bacteraemia in Adult\",\"authors\":\"Tiong Chan Lee, Asma’ Md Arif, Nurul Huda Razali, Vicknesan Kulaisingham, Hashvina Sukesh, Voon Yaa Tay, Mohd Ashraf Ghazali, Jin Koh Ewe, Sitinah Omar, Hamizan Othman, Toh Phang Teck\",\"doi\":\"10.31436/imjm.v22i4.2333\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"INTRODUCTION: Klebsiella pneumonia (K. pneumonia) bacteremia is one of the leading causes of hospital morbidity and mortality. Our study aimed to evaluate the clinical characteristics, risk factors and outcomes of K. pneumonia bacteremia in a Malaysian public hospital. MATERIALS AND METHODS: A retrospective cross-sectional study of adults with K. pneumonia bacteremia was conducted in a hospital in Johor, Malaysia. Demographics, medical comorbidities, source of infections and the mortality rate was reviewed and analyzed. RESULTS: A total of 185 cases of K. pneumonia bacteremia were included for analysis. The mean age for this study was 54.9 (SD 15.4), with 56.8% males and 46.5% in-hospital mortality. Extended-spectrum Beta Lactamase (ESBL) producing and Carbapenem-resistant K. pneumonia contributed to 37.3% and 1.1 % of K. pneumonia bacteremia, respectively. Among those who contracted K. pneumonia bacteremia, two most frequent sources were primary bloodstream infections (n=75, 40.5%), pneumonia (n=44, 23.8%) and urinary tract infections (n=28, 15.1%). There was statistically significant associations found between diabetes mellitus (AOR 1.46, 95% CI 1.02-2.08), cancer (AOR 2.02, 95% CI 1.33-3.05) and alcohol use disorder (AOR 7.73,95% CI 1.38-43.21 ) with K. pneumonia bacteremia. In-hospital mortality was higher in older patients by 1.03 odds (p=0.003). CONCLUSION: Diabetes mellitus, cancer, and alcohol use disorder were independent risk factors associated with K. pneumonia bacteremia. Patients with advanced age had a higher mortality rate.\",\"PeriodicalId\":53575,\"journal\":{\"name\":\"International Medical Journal Malaysia\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.3000,\"publicationDate\":\"2023-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Medical Journal Malaysia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.31436/imjm.v22i4.2333\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Medical Journal Malaysia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.31436/imjm.v22i4.2333","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
肺炎克雷伯氏菌菌血症是医院发病率和死亡率的主要原因之一。本研究旨在评估马来西亚一家公立医院肺炎克雷伯菌血症的临床特征、危险因素和结局。材料和方法:在马来西亚柔佛州的一家医院对成人肺炎克雷伯菌血症进行了回顾性横断面研究。对人口统计、医疗合并症、感染来源和死亡率进行了审查和分析。结果:185例肺炎克雷伯菌血症纳入分析。该研究的平均年龄为54.9岁(SD 15.4),男性占56.8%,住院死亡率为46.5%。产广谱β -内酰胺酶(ESBL)和耐碳青霉烯肺炎克雷伯菌血症分别占37.3%和1.1%。在感染肺炎克雷伯菌血症的患者中,两个最常见的来源是原发性血流感染(n=75, 40.5%)、肺炎(n=44, 23.8%)和尿路感染(n=28, 15.1%)。糖尿病(AOR 1.46, 95% CI 1.02-2.08)、癌症(AOR 2.02, 95% CI 1.33-3.05)和酒精使用障碍(AOR 7.73,95% CI 1.38-43.21)与肺炎克雷伯菌血症有统计学意义。老年患者住院死亡率高1.03倍(p=0.003)。结论:糖尿病、癌症和酒精使用障碍是肺炎克雷伯菌血症的独立危险因素。高龄患者死亡率较高。
Clinical Characteristics and Outcomes of Klebsiella Pneumonia Bacteraemia in Adult
INTRODUCTION: Klebsiella pneumonia (K. pneumonia) bacteremia is one of the leading causes of hospital morbidity and mortality. Our study aimed to evaluate the clinical characteristics, risk factors and outcomes of K. pneumonia bacteremia in a Malaysian public hospital. MATERIALS AND METHODS: A retrospective cross-sectional study of adults with K. pneumonia bacteremia was conducted in a hospital in Johor, Malaysia. Demographics, medical comorbidities, source of infections and the mortality rate was reviewed and analyzed. RESULTS: A total of 185 cases of K. pneumonia bacteremia were included for analysis. The mean age for this study was 54.9 (SD 15.4), with 56.8% males and 46.5% in-hospital mortality. Extended-spectrum Beta Lactamase (ESBL) producing and Carbapenem-resistant K. pneumonia contributed to 37.3% and 1.1 % of K. pneumonia bacteremia, respectively. Among those who contracted K. pneumonia bacteremia, two most frequent sources were primary bloodstream infections (n=75, 40.5%), pneumonia (n=44, 23.8%) and urinary tract infections (n=28, 15.1%). There was statistically significant associations found between diabetes mellitus (AOR 1.46, 95% CI 1.02-2.08), cancer (AOR 2.02, 95% CI 1.33-3.05) and alcohol use disorder (AOR 7.73,95% CI 1.38-43.21 ) with K. pneumonia bacteremia. In-hospital mortality was higher in older patients by 1.03 odds (p=0.003). CONCLUSION: Diabetes mellitus, cancer, and alcohol use disorder were independent risk factors associated with K. pneumonia bacteremia. Patients with advanced age had a higher mortality rate.
期刊介绍:
International Medical Journal Malaysia (IMJM) is the official journal of the Kulliyyah (Faculty) of Medicine, International Islamic University Malaysia. It serves primarily as a forum for education and intellectual discourse for health professionals namely in clinical medicine but covers diverse issues relating to medical ethics, professionalism as well as medical developments and research in basic medical sciences. It also serves the unique purpose of highlighting issues and research pertaining to the Muslim world. Contributions to the IMJM reflect its international and multidisciplinary readership and include current thinking across a range of specialties, ethnicities and societies.