Observational studyBMC pulmonary medicine2023
Clinical characteristics, risk factors and outcomes of Klebsiella pneumoniae pneumonia developing secondary Klebsiella pneumoniae bloodstream infection.
Observational study in BMC pulmonary medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed, 30 citations in OpenAlex.
- Clinical and genomic profiling ofVirulence · 2026Article
- Antimicrobial resistance and plasmidome of carbapenemase-resistant Klebsiella pneumoniae causing bloodstream infections between 2014 and 2024.BMC microbiology · 2026Article
- Determinants of Carbapenem-ResistantAntibiotics (Basel, Switzerland) · 2026Article
- Prevalence, antimicrobial resistance, and associated factors of critical superbugs Klebsiella pneumoniae and Acinetobacter species among hospitalized patients in Northwest Ethiopia.BMC microbiology · 2026Article
- Distribution, antibacterial resistance, biofilm formation, and risk factors associated with carbapenemase-producing gram-negative bacteria in ICU patients.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Characterization of Proline-Rich Antimicrobial Peptides with SbmA Transporter-Dependent and Independent Antimicrobial Activity towardACS infectious diseases · 2026Article
- A Pilot Study ofDiagnostics (Basel, Switzerland) · 2026Article
- Machine learning-assisted prognostic model for mortality in ICU patients with culture-confirmedFrontiers in cellular and infection microbiology · 2026Article
- O2a O-antigen type and sepsis in invasiveFrontiers in cellular and infection microbiology · 2026Article
- Klebsiella pneumoniae species complex bloodstream infection in adult patients: changing epidemiology and determinants of poor outcomes.Infection · 2025Article
- Antibiotic resistance in empyema thoracis: clinical outcomes and contributing factors in a tertiary care setting in Pakistan.IJID regions · 2025Article
- Carbapenem-resistant bacteria in the environment.Arhiv za higijenu rada i toksikologiju · 2025Review
- Research and predictive analysis of the disease burden of bloodstream infectious diseases in China.BMC infectious diseases · 2025Article
- The Inhibitory Effects ofJournal of microbiology and biotechnology · 2025Article
- Phage-antibiotic combinations againstFrontiers in microbiology · 2025Article
- Clinical Characteristics and Independent Risk Factors for Multidrug-ResistantInfection and drug resistance · 2025Article
- Dual threat: Susceptibility mechanisms and treatment strategies for COVID-19 and bacterial co-infections.Computational and structural biotechnology journal · 2025Review
- Clinical Outcomes and Mortality Predictors of Klebsiella Pneumoniae Pneumonia in Vietnamese Elderly: a Prospective Cohort Study.Medical archives (Sarajevo, Bosnia and Herzegovina) · 2025Article
- High Prevalence of Multidrug-resistantMateria socio-medica · 2025Article
- Varicella challenges: A case of respiratory tract complications in an elderly patient.Narra J · 2024Article
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe clinical characteristics of Klebsiella pneumoniae (KP) pneumonia and KP bloodstream infection (KP-BSI) are often reported, while the risk factors for KP pneumonia developing into secondary KP-BSI (KP-pneumonia/KP-BSI) are largely unknown. Therefore, this study attempted to investigate the clinical characteristics, risk factors and outcomes of KP-pneumonia/KP-BSI.
methodsA retrospective observational study was conducted at a tertiary hospital between January 1, 2018, and December 31, 2020. The patients were divided into groups of KP pneumonia alone and KP pneumonia/KP-BSI, and the clinical information were collected from medical records electronic system.
resultsA total of 409 patients were finally recruited. According to the multivariate logistic regression analysis, male sex (adjusted odds ratio [aOR] 3.7; 95% CI, 1.44-9.5), immunosuppression (aOR, 13.52; 95% CI, 2.53,72.22), APACHE II score higher than 21 (aOR, 3.39; 95% CI, 1.41-8.12), serum procalcitonin (PCT) levels above 1.8 ng/ml (aOR, 6.37; 95% CI, 2.67-15.27), ICU stay of more than 2.5 days before pneumonia onset (aOR, 1.09; 95% CI, 1.02,1.17), mechanical ventilation (aOR, 4.96; 95% CI, 1.2,20.5), Klebsiella pneumoniae isolates producing extended spectrum β-lactamase (ESBL-positive KP) (aOR, 12.93; 95% CI, 5.26-31.76), and inappropriate antibacterial therapy (aOR, 12.38; 95% CI, 5.36-28.58) were independent factors of KP pneumonia/KP BSI. In comparison with the patients with KP pneumonia alone, the patients with KP pneumonia/KP BSI showed an almost 3 times higher incidence of septic shock (64.4% vs. 20.1%, p < 0.01), a longer duration of mechanical ventilation, and longer lengths of ICU stay and total hospital stay (median days, 15 vs. 4,19 vs. 6, 34 vs. 17, respectively, both p < 0.01). Additionally, the overall in-hospital crude mortality rate in the patients with KP-pneumonia/KP-BSI was more than two times higher than that in those with KP pneumonia alone (61.5% vs. 27.4%, p < 0.01).
conclusionFactors including male sex, immunosuppression, APACHE II score higher than 21, serum PCT levels above 1.8 ng/ml, ICU stay of more than 2.5 days before pneumonia onset, mechanical ventilation, ESBL-positive KP, and inappropriate antibacterial therapy are independent risk factors for KP pneumonia/KP-BSI. Of note, the outcomes in patients with KP pneumonia worsen once they develop secondary KP-BSI, which merits more attention.
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