Comparison of Bacteraemic Community-Acquired Lobar Pneumonia due to <i>Streptococcus pneumoniae</i> and <i>Klebsiella pneumoniae</i> in an Intensive Care Unit

Abstract

In a study of 41 consecutive patients with bacteraemia-associated community-acquired lobar pneumonia due to Streptococcus pneumoniae and Klebsiella pneumoniae an attempt was made to determine whether distinguishing criteria of disease due to these organisms could be identified according to demographic features and the results of initial clinical and laboratory investigations. Such information would aid in the early initiation of appropriate antimicrobial therapy. The most significant difference between the two groups of patients was the lower platelet count in the K pneumoniae group (p < 0.005). In addition leucopenia (p < 0.05), higher serum albumin (p < 0.05), and the male sex (p < 0.05) featured with an increased frequency in patients with pulmonary infection due to K. pneumoniae. Initial antimicrobial therapy in critically ill patients with community-acquired lobar pneumonia and thrombocytopenia, particularly when associated with leucopenia and in male patients, should include agents effective against K. pneumoniae

Severe community-acquired pneumonia: assessment of microbial aetiology as mortality factor

“…This result is consistent with those reported in severe [2-11, 18, 19-23] and nonsevere CAP [12,32,33]. However, the high frequency of isolated K. pneumoniae (22%) is in contrast with the low percentage reported in most published CAP series, with the exception of studies conducted by FELDMAN et al [30,31] in South Africa. The current authors have no hypothesis to explain these similarities, except the location in the south hemisphere region, 2,500 km east of South Africa.…”

“…Alcohol abuse was the only RF correlated with death, but was also found to be more frequent in K. pneumoniae CAP compared with other CAPs (table 6). In the literature, alcoholism is generally associated with severe CAP and, particularly, with K. pneumoniae CAP [30,31]. However, the current authors found about half of patients with alcohol abuse in the non-K. pneumoniae group.…”

Platelet Antistaphylococcal Responses Occur through P2X 1 and P2Y 12 Receptor-Induced Activation and Kinocidin Release

“…For example, Sullam et al (33) observed that animals rendered selectively thrombocytopenic (but not neutropenic) have significantly worse infective endocarditis due to a PMPsusceptible strain of viridans group streptococci than animals with normal platelet counts. Human studies have also shown thrombocytopenia to be an independent risk factor for infection in organ transplant patients and other patient populations (5,12,35). To our knowledge, no prospective studies have specifically addressed potential relationships between platelet antagonism and an increased risk of infection due to S. aureus.…”

Pulmonary and Systemic Host Response toStreptococcus pneumoniaeandKlebsiella pneumoniaeBacteremia in Normal and Immunosuppressed Mice

“…A comparison of bacteremic community-acquired lobar pneumonia due to S. pneumoniae and Klebsiella pneumoniae in an intensive care unit already showed that thrombocytopenia and leukopenia feature with increased frequency in patients with pulmonary infection due to K. pneumoniae (9). However, the pathogenesis of lung injury induced by bacteremia in leukopenic patients after exposure to either microorganism has been poorly defined.…”