Klebsiella Pneumonia in the Modern Era

Korvick, J A; Hackett, Asher; Yu, Victor L.; Muder, R R

doi:10.1097/00007611-199102000-00012

Cited by 42 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While K . pneumoniae has been declining in the United States [12], it is still common in China [13], particularly in ventilator-associated pneumonia patients [14]. In this study, we found that the pathogen accounted for ~22% of all infected patients, and the pathogen is also common in patients with diabetes and pulmonary disorders.…”

Section: Discussionmentioning

confidence: 67%

Patterns of antimicrobial resistance in intensive care unit patients: a study in Vietnam

Tran

Ho-Le

et al. 2017

BMC Infect Dis

View full text Add to dashboard Cite

BackgroundAntimicrobial resistance has emerged as a major concern in developing countries. The present study sought to define the pattern of antimicrobial resistance in ICU patients with ventilator-associated pneumonia.MethodsBetween November 2014 and September 2015, we enrolled 220 patients (average age ~ 71 yr) who were admitted to ICU in a major tertiary hospital in Ho Chi Minh City, Vietnam. Data concerning demographic characteristics and clinical history were collected from each patient. The Bauer–Kirby disk diffusion method was used to detect the antimicrobial susceptibility.ResultsAntimicrobial resistance was commonly found in ceftriaxone (88%), ceftazidime (80%), ciprofloxacin (77%), cefepime (75%), levofloxacin (72%). Overall, the rate of antimicrobial resistance to any drug was 93% (n = 153/164), with the majority (87%) being resistant to at least 2 drugs. The three commonly isolated microorganisms were Acinetobacter (n = 75), Klebsiella (n = 39), and Pseudomonas aeruginosa (n = 29). Acinetobacter baumannii were virtually resistant to ceftazidime, ceftriaxone, piperacilin, imipenem, meropenem, ertapenem, ciprofloxacin and levofloxacin. High rates (>70%) of ceftriaxone and ceftazidime-resistant Klebsiella were also observed.ConclusionThese data indicated that critically ill patients on ventilator in Vietnam were at disturbingly high risk of antimicrobial resistance. The data also imply that these Acinetobacter, Klebsiella, and Pseudomonas aeruginosa and multidrug resistance pose serious therapeutic problems in ICU patients. A concerted and systematic effort is required to rapidly identify high risk patients and to reduce the burden of antimicrobial resistance in developing countries.

show abstract

Section: Discussionmentioning

confidence: 67%

Patterns of antimicrobial resistance in intensive care unit patients: a study in Vietnam

Tran

Ho-Le

et al. 2017

BMC Infect Dis

View full text Add to dashboard Cite

show abstract

“…Nonetheless, for the purposes of the remainder of this review, we consider K. pneumoniae strains that lack excessive capsule (see below) and, therefore, rarely cause disease in otherwise healthy individuals (with the exception of urinary tract infections) as "classical" strains regardless of whether they are multidrug resistant. Typically, classical K. pneumoniae strains cause serious infections, such as pneumonia, bacteremia, or meningitis, when infecting immunocompromised individuals, including people suffering from diabetes or malignancies (32)(33)(34). The carriage and expression of drug resistance do not enhance the virulence of K. pneumoniae strains despite making them more difficult to treat.…”

Section: Classical Antibiotic-resistant Emerging and Hypervirulentmentioning

confidence: 99%

“…K. pneumoniae is the underlying cause of ϳ11.8% of HAPs (50). K. pneumoniae HAP presents similarly to other nosocomial pneumonias, with respiratory symptoms that may include cough and unilateral pulmonary infiltrates and systemic symptoms that include fever and leukocytosis (34). These HAPs occur in both ventilated and nonventilated patients, and K. pneumoniae is the causative agent in 8 to 12% and 7% of these cases, respectively (58)(59)(60).…”

Section: Infections Caused By K Pneumoniaementioning

confidence: 99%

“…Risk factors for the acquisition of K. pneumoniae nosocomial bacteremia include malignancy, diabetes, chronic liver disease, solid-organ transplantation, and dialysis (32,33). Other risk factors for nosocomial infection are treatment with corticosteroids, chemotherapy (which can overlap in malignancy patients), transplantation, or other treatments or conditions resulting in neutropenia (34). For both HAPs and CAPs, the primary route of bacterial lung infection is by aspiration of microbes colonizing the oropharyngeal tract or, less commonly, the GI tract (54,96).…”

Section: Patient Risk Factorsmentioning

confidence: 99%

See 1 more Smart Citation

Klebsiella pneumoniae: Going on the Offense with a Strong Defense

Paczosa

Mecsas

2016

Microbiol Mol Biol Rev

1,366

1,345

View full text Add to dashboard Cite

SUMMARYKlebsiella pneumoniaecauses a wide range of infections, including pneumonias, urinary tract infections, bacteremias, and liver abscesses. Historically,K. pneumoniaehas caused serious infection primarily in immunocompromised individuals, but the recent emergence and spread of hypervirulent strains have broadened the number of people susceptible to infections to include those who are healthy and immunosufficient. Furthermore,K. pneumoniaestrains have become increasingly resistant to antibiotics, rendering infection by these strains very challenging to treat. The emergence of hypervirulent and antibiotic-resistant strains has driven a number of recent studies. Work has described the worldwide spread of one drug-resistant strain and a host defense axis, interleukin-17 (IL-17), that is important for controlling infection. Four factors, capsule, lipopolysaccharide, fimbriae, and siderophores, have been well studied and are important for virulence in at least one infection model. Several other factors have been less well characterized but are also important in at least one infection model. However, there is a significant amount of heterogeneity inK. pneumoniaestrains, and not every factor plays the same critical role in all virulentKlebsiellastrains. Recent studies have identified additionalK. pneumoniaevirulence factors and led to more insights about factors important for the growth of this pathogen at a variety of tissue sites. Many of these genes encode proteins that function in metabolism and the regulation of transcription. However, much work is left to be done in characterizing these newly discovered factors, understanding how infections differ between healthy and immunocompromised patients, and identifying attractive bacterial or host targets for treating these infections.

show abstract

Pneumonia

Seaton¹

2000

Crofton and Douglas's Respiratory Diseases

View full text Add to dashboard Cite

Klebsiella Pneumonia in the Modern Era

Cited by 42 publications

References 0 publications

Patterns of antimicrobial resistance in intensive care unit patients: a study in Vietnam

Patterns of antimicrobial resistance in intensive care unit patients: a study in Vietnam

Klebsiella pneumoniae: Going on the Offense with a Strong Defense

Pneumonia

Contact Info

Product

Resources

About