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Clinical characteristics of patients with pneumonia caused by Klebsiella pneumoniae in Taiwan and prevalence of antimicrobial-resistant and hypervirulent strains: a retrospective study

Authors
  • Juan, Chih-Han1, 2, 3
  • Fang, Shih-Yu3
  • Chou, Chia-Hsin3
  • Tsai, Tsung-Ying3
  • Lin, Yi-Tsung1, 3
  • 1 Taipei Veterans General Hospital, Number 201, Section 2, Shih-Pai Road, Beitou District, Taipei, 11217, Taiwan , Taipei (Taiwan)
  • 2 Puli Branch of Taichung Veterans General Hospital, Nantou, Taiwan , Nantou (Taiwan)
  • 3 National Yang-Ming University, Taipei, Taiwan , Taipei (Taiwan)
Type
Published Article
Journal
Antimicrobial Resistance & Infection Control
Publisher
BioMed Central
Publication Date
Jan 03, 2020
Volume
9
Issue
1
Identifiers
DOI: 10.1186/s13756-019-0660-x
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundWe aimed to compare the clinical characteristics of patients with community-acquired pneumonia (CAP), healthcare-associated pneumonia (HCAP), and hospital-acquired pneumonia (HAP) caused by Klebsiella pneumoniae and analyze the antimicrobial resistance and proportion of hypervirluent strains of the microbial isolates.MethodsWe conducted a retrospective study on patients with pneumonia caused by K. pneumoniae at the Taipei Veterans General Hospital in Taiwan between January 2014 and December 2016. To analyze the clinical characteristics of these patients, data was extracted from their medical records. K. pneumoniae strains were subjected to antimicrobial susceptibility testing, capsular genotyping and detection of the rmpA and rmpA2 genes to identify hypervirulent strains.ResultsWe identified 276 patients with pneumonia caused by K. pneumoniae, of which 68 (24.6%), 74 (26.8%), and 134 (48.6%) presented with CAP, HCAP, and HAP, respectively. The 28-day mortality was highest in the HAP group (39.6%), followed by the HCAP (29.7%) and CAP (27.9%) groups. The HAP group also featured the highest proportion of multi-drug resistant strains (49.3%), followed by the HCAP (36.5%) and CAP groups (10.3%), while the CAP group had the highest proportion of hypervirulent strains (79.4%), followed by the HCAP (55.4%) and HAP groups (41.0%).ConclusionPneumonia caused by K. pneumoniae was associated with a high mortality. Importantly, multi-drug resistant strains were also detected in patients with CAP. Hypervirulent strains were prevalent in all 3 groups of pneumonia patients, even in those with HAP.

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