Shengli Clinical Medical, College of Fujian Medical University, Fuzhou, China.
Clinical Microbiology Laboratory, Fujian Provincial Hospital, Fuzhou, China.
J Appl Microbiol. 2022 May;132(5):3883-3890. doi: 10.1111/jam.15476. Epub 2022 Feb 19.
To evaluate the clinical and genetic virulence characteristics of critically ill patients with hypervirulent Klebsiella pneumoniae (hvKP) and classic KP (cKP) infection.
The patients included in this retrospective study (n = 225) were grouped according to their hvKP (n = 114) or cKP (n = 111) status, and their clinical characteristics were analysed and compared. Cox multivariate analysis was conducted to determine the risk factors for hvKP infection. Length of hospital stay, length of intensive care unit stay, duration of mechanical ventilation and 28-day survival rate were similar between the groups. However, the incidence of septic shock was higher in the hvKP group (16.7%) than in the cKP group (8.1%).
There was a high rate of hvKP infection in this population. Compared to patients with cKP infection, those with hvKP infection showed a higher probability of having septic shock; nevertheless, survival and length of hospital stay were similar between the groups. Risk factors for hvKP infection included hospital-acquired infection and renal insufficiency.
This study presents relevant information on the characteristics of hvKP infection in a Chinese population, and this promotes early diagnosis and supports the view that the prevalence of hvKP is high in China.
评估危重症高毒力肺炎克雷伯菌（hvKP）和经典肺炎克雷伯菌（cKP）感染患者的临床和遗传毒力特征。
本回顾性研究纳入的患者（n=225）根据其 hvKP（n=114）或 cKP（n=111）状态进行分组，并对其临床特征进行分析和比较。采用 Cox 多变量分析确定 hvKP 感染的危险因素。两组患者的住院时间、重症监护病房住院时间、机械通气时间和 28 天生存率相似。然而，hvKP 组（16.7%）发生感染性休克的比例高于 cKP 组（8.1%）。
本研究人群中存在较高的 hvKP 感染率。与 cKP 感染患者相比，hvKP 感染患者发生感染性休克的可能性更高；然而，两组患者的生存率和住院时间相似。hvKP 感染的危险因素包括医院获得性感染和肾功能不全。
本研究提供了有关中国人群中 hvKP 感染特征的相关信息，这有助于早期诊断，并支持中国 hvKP 流行率较高的观点。
