NHIỄM KLEBSIELLA PNEUMONIAE: BỆNH CẢNH LÂM SÀNG VÀ KẾT QUẢ ĐIỀU TRỊ TẠI BỆNH VIỆN BỆNH NHIỆT ĐỚI TỪ 2020 ĐẾN 2021

Abstract

Background: Klebsiella pneumoniae infections represent an important health concern, which involves diverse clinical features and high mortality. A deep understanding of the diversity of the clinical presentations caused by K. pneumoniae is expected to a better treatment strategies implementation against this important pathogen. Objectives: To describe the clinical features and identify risk factors for mortality in patents with community and hospital acquired K. pneumoniae infection. Methods: A observational study of patients admitted to Hospital for Tropical Diseases from January 2020 to August 2021 had a positive culture of K. pneumoniae from at least one laboratory sample. Results: In 190 patients with K. pneumoniae infection that were recruited, community-acquired infection accounted for 66,8%. The mean age was 53,3±16,9 and 59,5% of the sample was male. 75,3% patients had prior chronic underlying diseases. All of the hospital-acquired infections were single-organ infection, with pneumonia accounted for 60,3%. Community-acquired infection represented with some distinct clinical features, including liver abscess (22,0%), meningitis (7,1%), and multi-organ infections (8,7%). The overall mortality was 22,9%. Factors related to increase mortality were consciousness alterations (OR 10,02 (2,7-37,0), renal impairment (OR 5,8 (2,2-15,5), and hospital-acquired infection (OR 3,96 (1,1-13,1). While urinary tract infection was associated with lower mortality ((OR 0,06 (0,01-0,40)). Conclusion: The study showed differences in clinical presentations due to K. pneumoniae infections between community and hospital-acquired infection. In addition to multi-drug resistant strains causing hospital-acquired infection, distinct clinical features of community-acquired hypervirulent K. pneumoniae should be noticed.