Differences in clinical outcomes of bloodstream infections caused by Klebsiella aerogenes, Klebsiella pneumoniae and Enterobacter cloacae: a multicentre cohort study

Background: Klebsiella aerogenes has been reclassified from Enterobacter to Klebsiella genus due to its phenotypic and genotypic similarities with Klebsiella pneumoniae. It is unclear if clinical outcomes are also more similar. This study aims to assess clinical outcomes of bloodstreams infections (...

Descripción completa

Detalles Bibliográficos
Autores: Guedes, Mariana, Gathara, David, López Hernández, Inmaculada, Martínez Pérez-Crespo, Pedro María, Pérez-Rodríguez , María Teresa, Sousa, Adrian, Plata, Antonio, Reguera-Iglesias , Jose María, Boix-Palop , Lucía, Dietl, Beatriz, Sevilla Blanco , Juan, Armiñanzas Castillo , Carlos, Galán-Sánchez , Fátima, Natera Kindelán , Clara, Jover-Saenz, Alfredo, Goikoetxea Aguirre , Josune, Alemán Alemán , Ana, Marrodán Ciordia , Teresa, Del Arco Jiménez , Alfonso, Fernandez-Suarez , Jonathan, Lopez-Cortes , Luis Eduardo, Rodríguez-Baño, Jesús
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10459.1/466043
Acceso en línea:https://doi.org/10.1186/s12941-024-00700-8
https://hdl.handle.net/10459.1/466043
Access Level:acceso abierto
Palabra clave:Enterobacter cloacae
Klebsiella aerogenes
Klebsiella pneumoniae
Bloodstream infection
Mortality
Recurrence
Descripción
Sumario:Background: Klebsiella aerogenes has been reclassified from Enterobacter to Klebsiella genus due to its phenotypic and genotypic similarities with Klebsiella pneumoniae. It is unclear if clinical outcomes are also more similar. This study aims to assess clinical outcomes of bloodstreams infections (BSI) caused by K. aerogenes, K. pneumoniae and Enterobacter cloacae, through secondary data analysis, nested in PRO-BAC cohort study. Methods: Hospitalized patients between October 2016 and March 2017 with monomicrobial BSI due to K. aerogenes, K. pneumoniae or E. cloacae were included. Primary outcome was a composite clinical outcome including all-cause mortality or recurrence until 30 days follow-up. Secondary outcomes were fever ≥ 72 h, persistent bacteraemia, and secondary device infection. Multilevel mixed-effect Poisson regression was used to estimate the association between microorganisms and outcome. Results: Overall, 29 K. aerogenes, 77 E. cloacae and 337 K. pneumoniae BSI episodes were included. Mortality or recurrence was less frequent in K. aerogenes (6.9%) than in E. cloacae (20.8%) or K. pneumoniae (19.0%), but statistical difference was not observed (rate ratio (RR) 0.35, 95% CI 0.08 to 1.55; RR 0.42, 95% CI 0.10 to 1.71, respectively). Fever ≥ 72 h and device infection were more common in K. aerogenes group. In the multivariate analysis, adjusted for confounders (age, sex, BSI source, hospital ward, Charlson score and active antibiotic therapy), the estimates and direction of effect were similar to crude results. Conclusions: Results suggest that BSI caused by K. aerogenes may have a better prognosis than E. cloacae or K. pneumoniae BSI.

Similares en LA Referencia