Author:
Lee Tiong Chan,Md Arif Asma’,Razali Nurul Huda,Kulaisingham Vicknesan,Sukesh Hashvina,Tay Voon Yaa,Ghazali Mohd Ashraf,Ewe Jin Koh,Omar Sitinah,Othman Hamizan,Teck Toh Phang
Abstract
INTRODUCTION: Klebsiella pneumonia (K. pneumonia) bacteremia is one of the leading causes of hospital morbidity and mortality. Our study aimed to evaluate the clinical characteristics, risk factors and outcomes of K. pneumonia bacteremia in a Malaysian public hospital. MATERIALS AND METHODS: A retrospective cross-sectional study of adults with K. pneumonia bacteremia was conducted in a hospital in Johor, Malaysia. Demographics, medical comorbidities, source of infections and the mortality rate was reviewed and analyzed. RESULTS: A total of 185 cases of K. pneumonia bacteremia were included for analysis. The mean age for this study was 54.9 (SD 15.4), with 56.8% males and 46.5% in-hospital mortality. Extended-spectrum Beta Lactamase (ESBL) producing and Carbapenem-resistant K. pneumonia contributed to 37.3% and 1.1 % of K. pneumonia bacteremia, respectively. Among those who contracted K. pneumonia bacteremia, two most frequent sources were primary bloodstream infections (n=75, 40.5%), pneumonia (n=44, 23.8%) and urinary tract infections (n=28, 15.1%). There was statistically significant associations found between diabetes mellitus (AOR 1.46, 95% CI 1.02-2.08), cancer (AOR 2.02, 95% CI 1.33-3.05) and alcohol use disorder (AOR 7.73,95% CI 1.38-43.21 ) with K. pneumonia bacteremia. In-hospital mortality was higher in older patients by 1.03 odds (p=0.003). CONCLUSION: Diabetes mellitus, cancer, and alcohol use disorder were independent risk factors associated with K. pneumonia bacteremia. Patients with advanced age had a higher mortality rate.