Hypervirulent Klebsiella pneumoniae-related bacteremia in intensive care unit: A retrospective cohort study

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Marin Moutel1, Edwidge Peju2, Martin Belan3

  • 1Équipe mobile d'infectiologie, Hôpitaux Universitaires Paris Centre-Cochin Port Royal, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.

Infectious Diseases Now
|March 23, 2024
PubMed
Abstract

Insights

Hypervirulent Klebsiella pneumoniae bloodstream infections (hvKP-BSI) are rare in the ICU. This study found hvKP-BSI disproportionately affects homeless patients with pneumonia, showing high mortality.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Microbiology

Background:

  • Hypervirulent Klebsiella pneumoniae (hvKP) bloodstream infections (BSI) are infrequently documented in critically ill patients.
  • Klebsiella pneumoniae bloodstream infections (KP-BSI) represent a significant clinical challenge.

Purpose of the Study:

  • To investigate the characteristics and outcomes of hvKP-BSI in an adult medical intensive care unit (ICU).
  • To identify risk factors and clinical presentations associated with hvKP-BSI.

Main Methods:

  • Retrospective study of KP-BSI cases from January 2016 to December 2020 in a tertiary care hospital ICU.
  • Hypervirulent phenotype defined by the presence of rmpA and iutA genes.
  • Comparison of clinical data between hvKP-BSI and classical KP-BSI (cKP-BSI) cohorts.

Main Results:

  • Nine out of seventy (13%) KP-BSI cases were identified as hvKP-BSI.
  • hvKP-BSI was significantly associated with pneumonia (56% vs 28%) and homelessness (56% vs 2%).
  • 30-day mortality was 44% for hvKP-BSI and 34% for cKP-BSI, not statistically different in multivariable analysis.

Conclusions:

  • A distinct clinical entity of hvKP-BSI associated with pulmonary infections in homeless individuals has been identified.
  • This hvKP-BSI presentation is linked to high mortality rates.
  • Further research is needed to understand the specific mechanisms and optimal management strategies for this population.

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