Occurrence and determinants of Klebsiella species bloodstream infection in the western interior of British Columbia, Canada

Abstract

BackgroundKlebsiella species are among the most common causes of bloodstream infection (BSI). However, few studies have evaluated their epidemiology in non-selected populations. The objective was to define the incidence of, risk factors for, and outcomes from Klebsiella species BSI among residents of the western interior of British Columbia, Canada.MethodsPopulation-based surveillance was conducted between April 1, 2010 and March 31, 2017.Results151 episodes were identified for an incidence of 12.1 per 100,000 population per year; the incidences of K. pneumoniae and K. oxytoca were 9.1 and 2.9 per 100,000 per year, respectively. Overall 24 (16%) were hospital-onset, 90 (60%) were healthcare-associated, and 37 (25%) were community-associated. The median patient age was 71.4 (interquartile range, 58.8–80.9) years and 88 (58%) cases were males. Episodes were uncommon among patients aged < 40 years old and no cases were observed among those aged < 10 years. A number of co-morbid medical illnesses were identified as significant risks and included (incidence rate ratio; 95% confidence interval) cerebrovascular accident (5.9; 3.3–9.9), renal disease 4.3; 2.5–7.0), cancer (3.8; 2.6–5.5), congestive heart failure (3.5; 1.6–6.6), dementia (2.9; 1.5–5.2), diabetes mellitus (2.6; 1.7–3.9), and chronic obstructive pulmonary disease (2.3; 1.5–3.5). Of the 141 (93%) patients admitted to hospital, the median hospital length stay was 8 days (interquartile range, 4–17). The in-hospital and 30-day all cause case-fatality rates were 24/141 (17%) and 27/151 (18%), respectively.ConclusionsKlebsiella species BSI is associated with a significant burden of illness particularly among those with chronic co-morbid illnesses.

Mortality in Escherichia coli bloodstream infections: a multinational population-based cohort study

“…For Klebsiella spp. BSIs, a study from Olmsted county (Minnesota, USA, 1998–2007) reported a 28-day case fatality risk of 14% with associated mortality rate of 1.6 deaths/100,000 person-years [ 41 ], and a study from western interior (BC, Canada, 04/01/2010–03/31/2017) identified a 30-day case fatality risk of 18% and a mortality rate of 2.2 deaths/100,000 person-years [ 42 ]. A study from Calgary (Alberta, Canada, 2000–2006) evaluating Pseudomonas aeruginosa BSIs reported an in-hospital case fatality risk of 29% with a mortality rate of 1.0 deaths/100,000 person-years [ 43 ].…”

Klebsiella pneumoniae bacteremia mortality: a systematic review and meta-analysis

“…Also, KP is the second most common cause of gram-negative bacteremia, following Escherichia coli (E. coli) ( Cubero et al., 2018 ; Hyun et al., 2018 ). The estimated incidence rate of Klebsiella pneumoniae bacteremia (KPB) was increased from 10.2 to 18.7 per 100 000 inhabitants in a region of Canada ( Pépin et al., 2010 ), and the reported mortality rate of KPB varied widely from 11% to 81% in most studies ( Chang et al., 2015 ; Imai et al., 2019 ; Reid et al., 2019 ; Falcone et al., 2020 ; Balkan et al., 2021 ; Meng et al., 2022 ). It is important to accurately estimate the mortality rate of KPB to best define the infectious disease, and it can accurately convey prognosis and improve the guidance to control this disease.…”

<p>Multi-Drug Resistant Post Corneal Repair <em>Klebsiella oxytoca</em>’s Keratitis</p>

“…The incidence case of Klebsiella oxytocainduced keratitis is far less than those of blood steam infections. 11 As far as our knowledge, there is only one case that was reported worldwide before this case. 4 In this case report, the isolated Klebsiella oxytoca strain was resistant to ampicillin, cefepime, chloramphenicol, and gentamicin.…”