Jung Jiwon, Park Ki-Ho, Park Seong Yeon, Song Eun Hee, Lee Eun Jung, Choi Seong-Ho, Choo Eun Ju, Kwak Yee Gyung, Sung Heungsup, Kim Sung-Han, Lee Sang-Oh, Kim Mi-Na, Kim Yang Soo, Woo Jun Hee, Choi Sang-Ho
Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, University of Ulsan, Seoul, Republic of Korea.
Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
Diagn Microbiol Infect Dis. 2015 May;82(1):87-91. doi: 10.1016/j.diagmicrobio.2015.02.006. Epub 2015 Feb 20.
This multicenter, retrospective cohort study compared the clinical characteristics and outcomes of community-acquired Klebsiella pneumoniae meningitis (CA-KPM) with those of community-acquired Streptococcus pneumoniae meningitis (CA-SPM). Eighty-three adult patients, 27 with CA-KPM and 56 with CA-SPM, were included. Diabetes mellitus (48.1% versus 21.4%; P=0.01) and liver cirrhosis (22.2% versus 5.4%; P=0.05) were more commonly associated with CA-KPM. Comatose mental status (40.7% versus 12.5%; P=0.01), septic shock (44.4% versus 8.9%; P<0.001), and concomitant extrameningeal infections (40.7% versus 7.1%; P=0.001) were also more common in the CA-KPM group. The 28-day mortality (44.4% versus 10.7%; P<0.001) and inhospital mortality (51.9% versus 14.3%; P<0.001) were higher in the CA-KPM group. In conclusion, diabetes mellitus and liver cirrhosis are more common in the CA-KPM patients who were also more likely to present with severe manifestations and poor outcomes.
这项多中心回顾性队列研究比较了社区获得性肺炎克雷伯菌脑膜炎（CA-KPM）与社区获得性肺炎链球菌脑膜炎（CA-SPM）的临床特征和结局。纳入了83例成年患者，其中27例为CA-KPM，56例为CA-SPM。糖尿病（48.1%对21.4%；P=0.01）和肝硬化（22.2%对5.4%；P=0.05）在CA-KPM患者中更为常见。昏迷状态（40.7%对12.5%；P=0.01）、感染性休克（44.4%对8.9%；P<0.001）和并发脑膜外感染（40.7%对7.1%；P=0.001）在CA-KPM组中也更常见。CA-KPM组的28天死亡率（44.4%对10.7%；P<0.001）和住院死亡率（51.9%对14.3%；P<0.001）更高。总之，糖尿病和肝硬化在CA-KPM患者中更为常见，这些患者也更有可能出现严重表现和不良结局。
