重症监护病房中与肺炎克雷伯菌相关的高病毒性菌血症：回顾性队列研究。

IF 2.9 4区医学 Q2 INFECTIOUS DISEASES Infectious diseases now Pub Date : 2024-03-22 DOI:10.1016/j.idnow.2024.104892

Marin Moutel , Edwidge Peju , Martin Belan , Ariane Gavaud , Jean-Paul Mira , Caroline Charlier , Etienne Canouï , Nabil Gastli

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摘要

导言：在重症患者中很少有关于高病毒性肺炎克雷伯菌（hvKP）血流感染（BSI）的报道：我们对三级甲等医院成人内科重症监护病房（ICU）2016 年 1 月至 2020 年 12 月间发生的 KP-BSI 进行了回顾性研究。通过检测 rmpA 和 iutA 来定义高病毒表型：结果：共纳入 70 例确诊为肺炎克氏菌 BSI 的患者，其中 9 例（13%）为 hvKP 感染。肺炎占 hvKP-BSI 的 56%，占 cKP 患者的 28%。56% 的 hvKP-BSI 患者无家可归，而 2% 的 cKP-BSI 患者无家可归（P）：我们在此证明了一种新的临床实体，即 hvKP-BSI 与无家可归的患者肺部感染有关，死亡率很高。

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Hypervirulent Klebsiella pneumoniae-related bacteremia in intensive care unit: A retrospective cohort study

Introduction

Hypervirulent Klebsiella pneumoniae (hvKP) bloodstream infections (BSI) have rarely been reported in critically ill patients.

Methods

We conducted a retrospective study of KP-BSI between January 2016 and December 2020 in an adult medical intensive care unit (ICU) of our tertiary care hospital. Hypervirulent phenotype was defined by the detection of both rmpA and iutA.

Results

Seventy patients diagnosed with K. pneumonia BSI were included, of whom 9 (13 %) had hvKP infection. Pneumonia accounted for 56 % of hvKP-BSI and for 28 % of those with cKP. Fifty-six percent of patients with hvKP-BSI were homeless, versus 2 % of those with cKP-BSI (p < 0.001). The 30-day mortality rate reached 44 % for hvKP-BSI and 34 % for cKP-BSI (p = 0.7) and did not appear related to the hypervirulent phenotype in multivariable analysis.