Hypervirulent Klebsiella pneumoniae-related bacteremia in intensive care unit: A retrospective cohort study

被引：7

作者：

Moutel, Marin ^{[1
]}

Peju, Edwidge ^{[2
,3
,4
]}

Belan, Martin ^{[1
,3
]}

Gavaud, Ariane ^{[2
]}

Mira, Jean -Paul ^{[2
,3
,4
]}

Charlier, Caroline ^{[1
,2
,3
,5
]}

Canoui, Etienne ^{[1
,7
]}

Gastli, Nabil ^{[6
]}

机构：

[1] Hop Univ Paris Ctr Cochin Port Royal, Assistance Publ Hop Paris AP HP, Equipe Mobile Infectiol, Paris, France

[2] Hop Univ Paris Ctr Cochin Port Royal, APHP, Serv Medecine Intens Reanimat, Serv Pathol, 27 Rue Faubourg St Jacques, Paris, France

[3] Univ Paris Cite, Paris, France

[4] Univ Paris Cite, Inst Cochin, INSERM U1016, CNRS ,UMR 8104, 22 Rue Mechain, F-75014 Paris, France

[5] Ctr Natl Reference Listeria, Inst Pasteur, Unit Biol Infect, Inserm U1117, F-75015 Paris, France

[6] Hop Univ Paris Ctr Cochin Port Royal, AP HP, Serv bacteriol, Paris, France

[7] Hop Cochin Port Royal, Antimicrobial Stewardship Team, 27 Rue Faubourg St Jacques, F-75014 Paris, France

来源：

INFECTIOUS DISEASES NOW | 2024年 / 54卷 / 05期

关键词：

D O I：

10.1016/j.idnow.2024.104892

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Introduction: Hypervirulent Klebsiella pneumoniae (hvKP) bloodstream infections (BSI) have rarely been reported in critically ill patients. Methods: We conducted a retrospective study of KP-BSI between January 2016 and December 2020 in an adult medical intensive care unit (ICU) of our tertiary care hospital. Hypervirulent phenotype was defined by the detection of both rmpA and iutA . Results: Seventy patients diagnosed with K. pneumonia BSI were included, of whom 9 (13 %) had hvKP infection. Pneumonia accounted for 56 % of hvKP-BSI and for 28 % of those with cKP. Fifty-six percent of patients with hvKP-BSI were homeless, versus 2 % of those with cKP-BSI (p < 0.001). The 30 -day mortality rate reached 44 % for hvKP-BSI and 34 % for cKP-BSI (p = 0.7) and did not appear related to the hypervirulent phenotype in multivariable analysis. Discussion: We here evidenced a new clinical entity of hvKP-BSI associated with pulmonary infection in homeless patients, which exhibits high mortality.

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共 14 条

[1] Carbapenem Resistance Conferred by OXA-48 in K2-ST86 Hypervirulent Klebsiella pneumoniae, France [J].

Beyrouthy, Racha ;

Dalmasso, Guillaume ;

Birer, Aurelien ;

Robin, Frederic ;

Bonnet, Richard .

EMERGING INFECTIOUS DISEASES, 2020, 26 (07) :1529-1533

[2] Clinical Epidemiology, Risk Factors, and Control Strategies of Klebsiella pneumoniae Infection [J].

Chang, De ;

Sharma, Lokesh ;

Dela Cruz, Charles S. ;

Zhang, Dong .

FRONTIERS IN MICROBIOLOGY, 2021, 12

[3] Multiplex PCR for Detection of Seven Virulence Factors and K1/K2 Capsular Serotypes of Klebsiella pneumoniae [J].

Compain, Fabrice ;

Babosan, Ana ;

Brisse, Sylvain ;

Genel, Nathalie ;

Audo, Jennifer ;

Ailloud, Florent ;

Kassis-Chikhani, Najiby ;

Arlet, Guillaume ;

Decre, Dominique .

JOURNAL OF CLINICAL MICROBIOLOGY, 2014, 52 (12) :4377-4380

[4] Hypervirulent Klebsiella pneumoniae clones causing bacteraemia in adults in a teaching hospital in Barcelona, Spain (2007-2013) [J].

Cubero, M. ;

Grau, I. ;

Tubau, F. ;

Pallares, R. ;

Dominguez, M. A. ;

Linares, J. ;

Ardanuy, C. .

CLINICAL MICROBIOLOGY AND INFECTION, 2016, 22 (02) :154-160

[5] Clinical and Molecular Characteristics of Klebsiella pneumoniae Isolates Causing Bloodstream Infections in Japan: Occurrence of Hypervirulent Infections in Health Care [J].

Harada, Sohei ;

Aoki, Kotaro ;

Yamamoto, Shungo ;

Ishii, Yoshikazu ;

Sekiya, Noritaka ;

Kurai, Hanako ;

Furukawa, Keiichi ;

Doi, Asako ;

Tochitani, Kentaro ;

Kubo, Kenji ;

Yamaguchi, Yukihiro ;

Narita, Masashi ;

Kamiyama, Shinya ;

Suzuki, Jun ;

Fukuchi, Takahiko ;

Gu, Yoshiaki ;

Okinaka, Keiji ;

Shiiki, Soichi ;

Hayakawa, Kayoko ;

Tachikawa, Natsuo ;

Kasahara, Kei ;

Nakamura, Tadahiro ;

Yokota, Kyoko ;

Komatsu, Masanari ;

Takamiya, Misaki ;

Tateda, Kazuhiro ;

Doi, Yohei .

JOURNAL OF CLINICAL MICROBIOLOGY, 2019, 57 (11)

[6] Risk factors and clinical outcomes of hypervirulent Klebsiella pneumoniae induced bloodstream infections [J].

Li, Jiayang ;

Ren, Jianan ;

Wang, Weiping ;

Wang, Gefei ;

Gu, Guosheng ;

Wu, Xiuwen ;

Wang, Ying ;

Huang, Mei ;

Li, Jieshou .

EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, 2018, 37 (04) :679-689

[7] Hypervirulent Klebsiella pneumoniae (hypermucoviscous and aerobactin positive) infection over 6 years in the elderly in China: antimicrobial resistance patterns, molecular epidemiology and risk factor [J].

Liu, Chao ;

Guo, Jun .

ANNALS OF CLINICAL MICROBIOLOGY AND ANTIMICROBIALS, 2019, 18 (1)

[8] Klebsiella variicola Is a Frequent Cause of Bloodstream Infection in the Stockholm Area, and Associated with Higher Mortality Compared to K. pneumoniae [J].

Maatallah, Makaoui ;

Vading, Malin ;

Kabir, Muhammad Humaun ;

Bakhrouf, Amina ;

Kalin, Mats ;

Naucler, Pontus ;

Brisse, Sylvain ;

Giske, Christian G. .

PLOS ONE, 2014, 9 (11)

[9] Invasive Klebsiella pneumoniae Infections, California, USA [J].

McCabe, Robert ;

Lambert, Larry ;

Frazee, Brad .

EMERGING INFECTIOUS DISEASES, 2010, 16 (09) :1490-1491

[10] Hypervirulent Klebsiella pneumoniae, a 5-year study in a French ICU [J].

Rafat, Cedric ;

Messika, Jonathan ;

Barnaud, Guilene ;

Dufour, Nicolas ;

Magdoud, Fatma ;

Billard-Pomares, Typhaine ;

Gaudry, Stephane ;

Dreyfuss, Didier ;

Branger, Catherine ;

Decre, Dominique ;

Ricard, Jean-Damien .

JOURNAL OF MEDICAL MICROBIOLOGY, 2018, 67 (08) :1083-1089