Ishiguro Takashi, Uozumi Ryuji, Yoshioka Hiroaki, Nishida Takashi, Takayanagi Noboru
Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan.
Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Japan.
Intern Med. 2020 Mar 1;59(5):611-618. doi: 10.2169/internalmedicine.3531-19. Epub 2019 Nov 22.
Objective In Japan, the aging demographic structure is becoming pronounced, and the full-blown graying of society appears not far off, which indicates an increasing population that will require healthcare contact. Klebsiella spp. are major pathogens in healthcare-associated infections, and their importance is increasing. The aim of this study was to clarify the characteristics of Klebsiella spp. chest infections by evaluating the differences in the characteristics of chest infections caused by Klebsiella spp. and pneumoniae. Methods We conducted a retrospective study of consecutive patients hospitalized with pneumonia, lung abscess/necrotizing pneumonia, and empyema due to Klebsiella spp. and S. pneumoniae for 15 years at our institution in Saitama, Japan. Patients Patients with chest infections due to Klebsiella spp. (K group, n=76) and S. pneumoniae (S group, n=446) were included. Results The K group more frequently was male, older, coinfected by Pseudomonas aeruginosa, and had diabetes mellitus, a history of upper digestive system surgery, alcohol drinking habit, a smoking habit, and an impaired premorbid performance status than the S group. The percentages of lung abscesses or necrotizing pneumonia (31.6% vs. 0.9%) and empyema without pulmonary parenchymal shadow (3.9% vs. 0.7%) were higher in the K group than those in the S group. Severity on admission and mortality did not differ between the groups; however, patients in the K group required a longer duration of antibiotics administration and hospital stay than those in the S group. Conclusion Klebsiella spp. chest infections have some marked characteristics when compared with pneumococcal infections, and our results serve to differentiate Klebsiella spp. infection from pneumococcal infection.
目的 在日本,人口老龄化结构日益明显,社会全面老龄化似乎已为期不远,这意味着需要医疗保健服务的人口在增加。克雷伯菌属是医疗保健相关感染中的主要病原体,其重要性日益增加。本研究的目的是通过评估克雷伯菌属和肺炎链球菌引起的胸部感染特征的差异,来阐明克雷伯菌属胸部感染的特点。方法 我们对在日本埼玉县我们机构连续15年因克雷伯菌属和肺炎链球菌导致肺炎、肺脓肿/坏死性肺炎及脓胸而住院的患者进行了一项回顾性研究。患者 纳入了因克雷伯菌属(K组,n = 76)和肺炎链球菌(S组,n = 446)引起胸部感染的患者。结果 与S组相比,K组男性更多、年龄更大、合并铜绿假单胞菌感染,且患有糖尿病、有上消化系统手术史、有饮酒习惯、有吸烟习惯以及病前表现状态受损。K组肺脓肿或坏死性肺炎的百分比(31.6% 对 0.9%)和无肺实质阴影的脓胸百分比(3.9% 对 0.7%)高于S组。两组入院时的严重程度和死亡率无差异;然而,K组患者抗生素使用时间和住院时间比S组患者更长。结论 与肺炎球菌感染相比,克雷伯菌属胸部感染有一些显著特征,我们的结果有助于区分克雷伯菌属感染和肺炎球菌感染。