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Multicenter Study
. 2024 May 6;23(1):42.
doi: 10.1186/s12941-024-00700-8.

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

Mariana Guedes #  1   2 , David Gathara #  3 , Inmaculada López-Hernández  4   5 , Pedro María Martínez Pérez-Crespo  6 , María Teresa Pérez-Rodríguez  7 , Adrian Sousa  7 , Antonio Plata  8 , Jose María Reguera-Iglesias  8 , Lucía Boix-Palop  9 , Beatriz Dietl  9 , Juan Sevilla Blanco  10 , Carlos Armiñanzas Castillo  5   11 , Fátima Galán-Sánchez  12 , Clara Natera Kindelán  13 , Alfredo Jover-Saenz  14 , Josune Goikoetxea Aguirre  15 , Ana Alemán Alemán  16 , Teresa Marrodán Ciordia  17 , Alfonso Del Arco Jiménez  18 , Jonathan Fernandez-Suarez  19 , Luis Eduardo Lopez-Cortes #  4   5 , Jesús Rodríguez-Baño #  4   5 ; PROBAC/GEIRAS-SEIMC/SAMICEI group
Collaborators, Affiliations
Multicenter Study

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

Mariana Guedes et al. Ann Clin Microbiol Antimicrob. .

Abstract

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.

Keywords: Enterobacter cloacae; Klebsiella aerogenes; Klebsiella pneumoniae; Bloodstream infection; Mortality; Recurrence.

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Conflict of interest statement

LELC has been scientific advisor for Angelini, speaker for Angelini, ViiV, Gilead and Correvio, and has served as trainer for ViiV. JRB. has received honoraria from Merck for accredited educational activities. The other authors report no conflicts of interest relevant to this article.

Figures

Fig. 1
Fig. 1
Kaplan–Meier curve: cumulative survival by microorganism
See this image and copyright information in PMC

References

    1. Goto M, Al-Hasan MN. Overall burden of bloodstream infection and nosocomial bloodstream infection in North America and Europe. Clin Microbiol Infect. 2013;19(6):501–509. doi: 10.1111/1469-0691.12195. - DOI - PubMed
    1. Murray CJ, Ikuta KS, Sharara F, Swetschinski L, Aguilar GR, Gray A, et al. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. The Lancet. 2022;399(10325):629–655. doi: 10.1016/S0140-6736(21)02724-0. - DOI - PMC - PubMed
    1. Digiovine B, Chenoweth C, Watts C, Higgins M. The attributable mortality and costs of primary nosocomial bloodstream infections in the intensive care unit. Am J Respir Crit Care Med. 1999;160(3):976–981. doi: 10.1164/ajrccm.160.3.9808145. - DOI - PubMed
    1. Riu M, Chiarello P, Terradas R, Sala M, Garcia-Alzorriz E, Castells X, et al. Cost attributable to nosocomial bacteremia: analysis according to microorganism and antimicrobial sensitivity in a University Hospital in Barcelona. PLoS ONE. 2016;11(4):e0153076. doi: 10.1371/journal.pone.0153076. - DOI - PMC - PubMed
    1. Albrecht SJ, Fishman NO, Kitchen J, Nachamkin I, Bilker WB, Hoegg C, et al. Reemergence of gram-negative health care-associated bloodstream infections. Arch Intern Med. 2006;166(12):1289–1294. doi: 10.1001/archinte.166.12.1289. - DOI - PubMed

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