KURUP A, LOYOLA FC, THUAN TONG T, ANBIAH RP, BAN HOCK T; Interscience Conference on Antimicrobial Agents and Chemotherapy (42nd : 2002 : San Diego, Calif.).
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2002 Sep 27-30; 42: abstract no. L-1961.
Singapore General Hospital, Singapore 169608, Singapore.
BACKGROUND:An invasive community-acquired klebsiella syndrome involving multiple foci of infection occurs more frequently in Taiwan than in the West. This entity has not been previously reported in Singapore. Data is also lacking on any difference between nosocomial and community-acquired klebsiella infection. METHODS: This is a retrospective study of all patients admitted to our institution between 1st January 2000 and 31st December 2000 with at least a single blood culture isolate of klebsiella spp. Blood culture isolation within 48 hours of admission distinguished community from nosocomial infection. RESULTS: Data was available for 185 (77%)of 240 patients. The majority were older than 60 years (58%), males (58%), ethnic Chinese (83%)and had diabetes mellitus or malignancy (32% each). Sixty-six percent(n=122)of cases were community-acquired. Invasive disease, defined as bacteremia and at least two other foci of infection, was evident in 10%(n=12)of patients with community-acquired infection and in only one patient with nosocomial infection. Brain abscesses, meningitis, necrotizing fasciitis, and endopthalmitis were part of this disseminated syndrome and were conspicuously absent in nosocomial infections. Liver abscesses developed in 11 (9%)patients all of whom had community-acquired infections. All klebsiella isolates were resistant to ampicillin. Thirteen percent and 16% of nosocomial strains were resistant to cefepime and ceftriaxone respectively. Overall mortality was 35%;commoner in nosocomial infections (21% vs 14%). CONCLUSIONS: An invasive septic syndrome may complicate one out of every 10 patients in Singapore infected with klebsiella from the community, representing an emerging infectious diseases entity. Intriguingly, nosocomial klebsiella infection behaves differently with less dissemination.
Publication Types:
Keywords:
- Bacteremia
- Brain Abscess
- Community-Acquired Infections
- Cross Infection
- Fasciitis, Necrotizing
- Humans
- Klebsiella
- Klebsiella Infections
- Klebsiella pneumoniae
- Liver Abscess
- Male
- Pneumonia
- Retrospective Studies
- Singapore
- Taiwan
Other ID:
UI: 102267443
From Meeting Abstracts