Analisis of Klebsiella pneumoniae bacteremias in patients from Mexico hospital
DOI:
https://doi.org/10.51481/amc.v58i2.921Keywords:
Klebsiella pneumoniae, ESBL (extended spectrum β-lactamase), bacteremia, neutropeniaAbstract
Background: In the last years there has been a worldwide increase of ESBL-producing Klebsiella
pneumoniae bacteraemias, which have been an important factor of resistance to β-lactam
antibiotics, and of nosocomial morbidity and mortality. It is relevant to day-to-day practice to know the incidence, risk factors, complications and lethality of these infections in the Mexico hospital. We proposed to register the most frequent sites of infection by Klebsiella pneumoniae, the production of ESBLs and its association to bacteremia and lethality.
Methods: A retrospective review was performed in patients from the Mexico hospital that developed a Klebsiella pneumoniae bacteremia from January 2008 to December 2011. We studied a total of 118 patients that developed non-ESBL-producing Klebsiella pneumonia and ESBL-producing Klebsiella pneumoniae. Demographic, clinical and microbiological data was recorded for all patients.
Results: Non-ESBL-producing Klebsiella pneumoniae and ESBL-producing Klebsiella pneumoniae cases are found frequently in the Mexico hospital. We found that urinary tract infection by ESBLproducing Klebsiella pneumoniae bacteremia is the most frequent. Risk factors like anemia, foley catheter, previous and concomitant infection, and previous use of cephalosphorines increase the risk of ESBL-producing Klebsiella pneumoniae bacteremia (CI95%: 1.1-12.3%). Also neutropenia, renal failure, foley catheter and an inadequate treatment in patients with ESBL-producing Klebsiella pneumoniae increase lethality (CI95%:1.1-39.8%). Nevertheless in patients with ESBL-producing Klebsiella pneumoniae bacteremia, the presence of ESBL doesn`t increase lethality. The 30-day lethality rate was 19% for both groups.
Conclusion: Klebsiella pneumoniae bacteremias are a serious problem in our hospital, with specific risk factors, treated adequately most of the time, but with a high lethality rate.
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