지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2012.1
- 수록면
- 56 - 61 (6page)
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초록· 키워드
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Background: Although healthcare-associated (HCA) Klebsiella pneumoniae bacteremia constitutes a significant proportion of community-onset infection cases, its clinical and microbiologic characteristics have yet to be described in detail. In this study, we sought to delineate the clinical differences between community-associated (CA) and HCA K.
pneumoniae bacteremia.
Materials and methods: A total of 240 patients infected by community-onset K.
pneumoniae bacteremia were included in this study, and the data from the patients with HCA K. pneumoniae bacteremia were compared to those with the CA bacteremia.
Isolates were microbiologically characterized and serotyped using a PCR method.
Results: Of the total 240 patients infected with community-onset K. pneumoniae bacteremia,140 (58.3%) were defined as HCA infection cases, and the remaining 100 patients were classified as CA infections. Multivariate analysis showed that use of percutaneous tubes, occurrence of a recent surgical operation, cases of pneumonia,neutropenia and solid tumor, and prior receipt of antibiotics were all significant factors associated with HCA bacteremia infection (all P<0.05). In terms of microbiologic characteristics, ciprofloxacin resistance (12.9% [18/140] vs. 4.0% [4/100], P=0.02) and extended-spectrum β-lactamase production (12.1% [17/140] vs. 4.0% [4/100], P =0.03)were more common in HCA bacteremia than CA bacteremia, respectively. The K1 and K2 serotypes, which are considered virulent community strains, were observed to exist more frequently in CA bacteremia than in HCA bacteremia (34% [34/100] vs. 21.4%[30/140], P=0.03). The overall 30-day mortality of the study population was 17.5%(37/211), and there was a trend toward greater mortality in the HCA group than in the CA group (21.4% [27/126] vs. 11.8% [10/85]; P=0.07).
Conclusions: Patients infected with HCA bacteremia accounted for a substantial proportion of all patients with community-onset K. pneumoniae bacteremia, and showed significantly different clinical and microbiological characteristics than those infected with CA bacteremia. HCA K. pneumoniae bacteremia represented a distinct subset of community-onset bacteremia characterized by antibiotic resistant pathogens, a finding which physicians should consider in providing optimal treatment of these cases.
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참고문헌 (21)
참고문헌 신청
Benito N. / 2009 / Health care-associated native valve endocarditis : importance of non-nosocomial acquisition / Ann Intern Med 150 : 586 ~ 594
Bone RC. / 1992 / Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. Americ
Charlson ME. / 1987 / A new method of classifying prognostic comorbidity in longitudinal studies : development and validation / J Chronic Dis 40 : 373 ~ 383
Cheong HS. / 2007 / Clinical significance of healthcare-associated infections in community-onset Escherichia coli bacteraemia / J Antimicrob Chemother 60 : 1355 ~ 1360
Chung DR. / 2008 / Evidence for clonal dissemin
Bone RC. / 1992 / Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. Americ
Charlson ME. / 1987 / A new method of classifying prognostic comorbidity in longitudinal studies : development and validation / J Chronic Dis 40 : 373 ~ 383
Cheong HS. / 2007 / Clinical significance of healthcare-associated infections in community-onset Escherichia coli bacteraemia / J Antimicrob Chemother 60 : 1355 ~ 1360
Chung DR. / 2008 / Evidence for clonal dissemin
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