KHẢO SÁT ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ KẾT CỤC VIÊM PHỔI DO KLEBSIELLA PNEUMONIAE TẠI BỆNH VIỆN CHỢ RẪY

Abstract

Background: Pneumonia caused by Klebsiella pneumoniae has gained attention due to the increasing incidence of infections caused by this pathogen, its growing antibiotic resistance, and its significant presence in both community-acquired and hospital-acquired pneumonia. Individuals with compromised immune systems, including elderly men, those with malignancies, type 2 diabetes, chronic liver disease, organ transplant recipients, or patients undergoing dialysis, are at high risk of K. pneumoniae infection. Identifying risk factors and predicting mortality in patients with pneumonia caused by K. pneumoniae is critical in clinical practice. Objectives: To determine the mortality rate and identify risk factors associated with mortality in patients with pneumonia caused by K. pneumoniae at Cho Ray Hospital. Subject and method: A retrospective review of medical records was conducted for patients diagnosed with pneumonia caused by K. pneumoniae and treated at Cho Ray Hospital from August 2022 to October 2024. Result: A total of 154 patients with K. pneumoniae pneumonia were included in the study. The average age was 62,2 years, with 68,8% of patients being male. The average length of hospital stay was 15 days (10-21 days), and the mortality rate was 42,9%. Hypertension and type 2 diabetes were the most common comorbidities. The average SOFA score was 4 (2-7), and the average APACHE II score was 15 (11-20). The incidence of septic shock was 27,3%, acute kidney injury occurred in 21,4%, and 60,4% of patients required mechanical ventilation. Approximately 49,4% of patients received appropriate antibiotic therapy. Independent factors predicting mortality risk included: SOFA score (OR=1,5, 95% CI: 1,1–2,0), concurrent myocardial infarction (OR=16,1, 95% CI: 1,4–181,5), and the use of Colistin-Carbapenem combination therapy for severe illness (OR=3,3, 95% CI: 1,2–8,7)). Conclusion: The mortality rate in patients with K. pneumoniae pneumonia is 42,9%. The SOFA score, concurrent myocardial infarction, and the use of Colistin-Carbapenem combination therapy are independent factors predicting mortality risk in these patients.