ArticleAnnals of intensive care2024
Community-acquired Klebsiella pneumoniae pneumonia in ICU: a multicenter retrospective study.
Article in Annals of intensive care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Alcohol's Effects on the Lung and Lung Disease.Alcohol research : current reviews · 2025Pooled it
- Global Trends in Antimicrobial Resistance-Related Mortality fromTropical medicine and infectious disease · 2026Article
- Factors associated with severity inNew microbes and new infections · 2026Article
- Article
- Review
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- Genomically defined hypervirulent Klebsiella pneumoniae contributed to early-onset increased mortality.Nature communications · 2025Article
- High Prevalence of Multidrug-resistantMateria socio-medica · 2025Article
- Serum valeric acid stimulates lung epithelial cilia assembly and improves prognosis in patients with severe respiratory infections.Frontiers in pharmacology · 2025Article
- Clinical Outcomes and Mortality Predictors of Klebsiella Pneumoniae Pneumonia in Vietnamese Elderly: a Prospective Cohort Study.Medical archives (Sarajevo, Bosnia and Herzegovina) · 2025Article
- Phage-antibiotic combinations againstFrontiers in microbiology · 2025Article
- The clinical prediction model to distinguish between colonization and infection byFrontiers in microbiology · 2024Article
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlongside the recent worldwide expansion of hypervirulent Klebsiella pneumoniae (KP) infections, the available literature regarding cases of community acquired pneumonias (KP-CAP) remains scarce but reports a strikingly high and early mortality. We performed a retrospective multicenter study (7 ICU in France) between 2015 and 2019, comparing prognosis and severity of KP-CAP versus Streptococcus pneumoniae - CAP (SP-CAP).
methodsFor each KP-CAP, three SP-CAP admitted in ICUs within the same center and within the same 6-month window were selected. When available, KP strains were studied, and bacterial virulence was genetically assessed for virulence factors. The primary outcome was in-hospital mortality. Associations between clinical outcomes and type of infection were tested using univariate and multivariate logistic regressions, adjusted for pairing variables.
resultsTwenty-seven KP-CAP and 81 SP-CAP were included. Respective in-hospital mortality rates were 59% (n = 16) and 17% (n = 14, p < 0.001), despite adequate antibiotic therapy. KP-CAP median time from admission to death was 26.9 h [IQR 5.75-44 h] and were significantly associated with higher rates of multiple organ failures (93% vs. 42%, p < 0.001), disseminated intravascular coagulation (12% vs. 1.3%, p = 0.046), septic shock (median lactate on ICU admission 4.60 vs. 2.90 mmol/L, p = 0.030) and kidney failure (KDIGO-3: 87% vs. 44%, p < 0.001). Interestingly, alcoholism was the only identified predisposing factor of KP-CAP. Severity on ICU admission (2-fold higher for KP-CAP) was the only factor associated with mortality in a multivariate analysis.
conclusionWe described a strong association between KP-CAP infection and higher and earlier mortality when compared to SP-CAP. Moreover, alcoholism was the sole predisposing factor associated with KP-CAP infection. These findings should raise awareness of clinicians involved in the management of severe CAP about this microbiological etiology. Future prospective studies are needed to confirm these results and to design strategies to improve the prognosis of such infections.
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