Starzyk-Łuszcz Katarzyna, Zielonka Tadeusz M, Jakubik Joanna, Życińska Katarzyna
Tadeusz Galamon Medical Practice, Nieporet, Poland.
Department of Family Medicine, Warsaw Medical University, 1A Banacha Street, 02-097, Warsaw, Poland.
Adv Exp Med Biol. 2017;1022:19-26. doi: 10.1007/5584_2017_38.
Klebsiella pneumoniae is one of the most important hospital pathogens, particularly concerning the multidrug-resistant strain ESBL. The aim of this study was to evaluate nosocomial infections with K. pneumoniae ESBL in the context of infection location, risk factors, and prognosis. This hospital study was conducted retrospectively and covered a 3 months' period. The infection with K. pneumoniae ESBL was diagnosed in 36 patients (19 women and 17 men) of the mean age of 74.2 ± 14.8 years. The number of infected patients amounted to 2.2% of all patients admitted to Czerniakowski Hospital in Warsaw, Poland, over the study time. Twenty of these patients died (13 women and 7 men), representing 14% of all hospital deaths at the time. The infection with K. pneumoniae ESBL occurred most frequently in the department of internal diseases, and rarely in neurology or intensive care wards. Bacteria was most often isolated from the urine, with the most distinct association between the use of urinary catheters and death (p = 0.019). We conclude that infections with K. pneumoniae ESBL were associated with over 55% mortality and usually occurred in the setting of internal diseases. Deaths due to K. pneumoniae ESBL infection were significantly related to the use of urinary bladder catheters.
肺炎克雷伯菌是最重要的医院病原体之一，尤其是多重耐药菌株产超广谱β-内酰胺酶（ESBL）的肺炎克雷伯菌。本研究的目的是在感染部位、危险因素和预后的背景下评估产ESBL肺炎克雷伯菌的医院感染情况。这项医院研究是回顾性的，涵盖了3个月的时间段。36例患者（19名女性和17名男性）被诊断为产ESBL肺炎克雷伯菌感染，平均年龄为74.2±14.8岁。在研究期间，感染患者数量占波兰华沙Czerniakowski医院所有入院患者的2.2%。其中20例患者死亡（13名女性和7名男性），占当时医院所有死亡人数的14%。产ESBL肺炎克雷伯菌感染最常发生在内科，很少发生在神经科或重症监护病房。细菌最常从尿液中分离出来，导尿管的使用与死亡之间的关联最为明显（p = 0.019）。我们得出结论，产ESBL肺炎克雷伯菌感染与超过55%的死亡率相关，通常发生在内科疾病背景下。产ESBL肺炎克雷伯菌感染导致的死亡与使用膀胱导尿管显著相关。
