Correlation between Clinical Prognostic Factors and CAP Patients’ Output due to Klebsiella Pneumoniae

Authors

  • Handriyani Department of Cardiovascular, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Hospital, Surabaya 60131, Indonesia Author
  • Laksmi Wulandari Department of Cardiovascular, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Hospital, Surabaya 60131, Indonesia Author

DOI:

https://doi.org/10.61841/dvvynr20

Keywords:

Community-Acquired Pneumonia, K. pneumoniae, clinical prognostic factors, infection

Abstract

Background: Infections of K. pneumoniae are often thought to be associated with higher mortality rates; this etiology has not been proven to be a clinical prognostic factor of death.

Objectives: to evaluate the relationship between age, sex, delay of antibiotic administration, smoking status, hemoglobin, albumin, Chronic Obstructive Pulmonary Disease (COPD), diabetes mellitus (DM), cardiovascular disease, Patients Outcome Research Team (PORT) score, antibiotic resistance, extended-spectrum β-lactamase (ESBL) strain through treatment length, ICU admission indication, and mortality of community-acquired pneumonia (CAP) patients caused by K. pneumoniae.

Method: The CAP patients infected with K. pneumoniae in the male and female pulmonology room of Dr. Soetomo General Hospital, Surabaya, Indonesia, from 1 January 2009 to 31 December 2012 were analyzed in a retrospective cohort. Observed outcomes included treatment length, ICU admission indication, and mortality.

Result: The sample size fulfilling the inclusion was 41 patients. There was a significant correlation between comorbid COPD (10.000 OR, p = 0.018), DM (0.714 OR, p = 0.040), and PORT score (1.471 OR; p = 0.014) through ICU outpatient indications. In multivariate analysis, comorbid COPD (p = 0.013) was the most dominant independent factor through ICU indication care, whereas albumin (p = 0.040) and ESBL germs (p = 0.027) were the same dominant independent factors for mortality.

Conclusion: There was a relationship between comorbid COPD, DM, and PORT score on ICU indication care in univariate analysis. 

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References

[1] Lutfiyya MN, Henley E, Chang LF, Reyburn SW. Diagnosis and treatment of community-acquired pneumonia. American family physician. 2006;73(3):442-50.

[2] Prasad R. Community-acquired pneumonia: clinical manifestations. The Journal of the Association of Physicians of India. 2012;60 Suppl:10-2.

[3] Goetz MB, Rhew, D.C., Torres, A. Pyogenic bacterial pneumonia, lung abscess, and empyema. 4th ed. Nadel’s Ma, editor 2005.

[4] Paganin F, Lilienthal F, Bourdin A, Lugagne N, Tixier F, Génin R, Yvin JL. Severe community-acquired pneumonia: assessment of microbial aetiology as mortality factor. The European respiratory journal. 2004;24(5):779-85. https://doi.org/10.1183/09031936.04.00119503

[5] Christ-Crain M, Stolz D, Bingisser R, Müller C, Miedinger D, Huber PR, Zimmerli W, Harbarth S, Tamm M, Müller B. Procalcitonin guidance of antibiotic therapy in community-acquired pneumonia: a randomized trial. American journal of respiratory and critical care medicine. 2006;174(1):84-93. https://doi.org/10.1164/rccm.200512-1922OC

[6] Soedarsono. Pneumonia In Wibisono MJ, Winariani, Hariadi S (eds), Buku Ajar Ilmu Penyakit Paru, Departemen Ilmu Penyakit Paru FK UNAIR-RSUD Dr. Soetomo Surabaya. 2010.

[7] Vandijck DM, Decruyenaere JM, Depuydt PO, Blot SI. Community-acquired versus nosocomial Klebsiella pneumonia bacteremia: clinical features, treatment outcomes, and clinical implication of antimicrobial resistance. Journal of Korean Medical Science. 2007;22(4):770-1.

[8] Huang HH, Zhang YY, Xiu QY, Zhou X, Huang SG, Lu Q, Wang DM, Wang F. Community-acquired pneumonia in Shanghai, China: microbial etiology and implications for empirical therapy in a prospective study of 389 patients. European journal of clinical microbiology & infectious diseases: official publication of the European Society of Clinical Microbiology. 2006;25(6):369-74. https://doi.org/10.1007/s10096-006-0146-7

[9] Bansal S, Kashyap S, Pal LS, Goel A. Clinical and bacteriological profile of community-acquired pneumonia in Shimla, Himachal Pradesh. The Indian journal of chest diseases & allied sciences. 2004;46(1):17-22.

[10] Hawkey PM. Prevalence and clonality of extended-spectrum beta-lactamases in Asia. Clinical microbiology and infection: the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 2008;14 Suppl 1:159-65. https://doi.org/10.1111/j.1469- 0691.2007.01855.x

[11] Turner PJ. Extended-spectrum beta-lactamases. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America. 2005;41 Suppl 4:S273-5. https://doi.org/10.1086/430789

[12] Bartlett JG, Mundy, L.M. Current concepts: community-acquired pneumonia. The New England journal of medicine. 1995;333:1618–1624. https://doi.org/10.1056/NEJM199512143332408

[13] Rello J, Rodriguez A, Torres A, Roig J, Sole-Violan J, Garnacho-Montero J, de la Torre MV, Sirvent JM, Bodi M. Implications of COPD in patients admitted to the intensive care unit by community-acquired pneumonia. The European respiratory journal. 2006;27(6):1210-6. https://doi.org/10.1183/09031936.06.00139305

[14] Snijders D, van der Eerden M, de Graaff C, Boersma W. The influence of COPD on mortality and

severity scoring in community-acquired pneumonia. Respiration; international review of thoracic

diseases. 2010;79(1):46-53. https://doi.org/10.1159/000213757

[15] Suter-Widmer I, Christ-Crain M, Zimmerli W, Albrich W, Mueller B, Schuetz P; ProHOSP Study Group. Predictors for length of hospital stay in patients with community-acquired pneumonia: results from a Swiss multicenter study. BMC pulmonary medicine. 22012; 12:21 https://doi.org/10.1186/1471-2466-12-21

[16] Kaplan V, Angus DC, Griffin MF, Clermont G, Scott Watson R, Linde-Zwirble WT. Hospitalized community-acquired pneumonia in the elderly: age- and sex-related patterns of care and outcome in the United States. American journal of respiratory and critical care medicine. 2002;165(6):766-72. https://doi.org/10.1164/ajrccm.165.6.2103038

[17] Restrepo MI, Mortensen EM, Pugh JA, Anzueto A. COPD is associated with increased mortality in patients with community-acquired pneumonia. The European respiratory journal. 2006;28(2):346-51. https://doi.org/10.1183/09031936.06.00131905

[18] Laserna E, Sibila O, Aguilar PR, Mortensen EM, Anzueto A, Blanquer JM, Sanz F, Rello J, Marcos PJ, Velez MI, Aziz N, Restrepo MI. Hypocapnia and hypercapnia are predictors for ICU admission and mortality in hospitalized patients with community-acquired pneumonia. Chest. 2012;142(5):1193-9. https://doi.org/10.1378/chest.12-0576

[19] McAlister FA, Majumdar SR, Blitz S, Rowe BH, Romney J, Marrie TJ. The relation between hyperglycemia and outcomes in 2,471 patients admitted to the hospital with community-acquired pneumonia. Diabetes care. 2005;28(4):810-5. https://doi.org/10.2337/diacare.28.4.810

[20] Lepper PM, Ott S, Nuesch E, von Eynatten M, Schumann C, Pletz MW, et al. Serum glucose levels for predicting death in patients admitted to hospital for community-acquired pneumonia: prospective cohort study. Bmj. 2012;344:e3397. https://doi.org/10.1136/bmj.e3397

[21] Catrina SB, Okamoto K, Pereira T, Brismar K, Poellinger L. Hyperglycemia regulates hypoxia-inducible factor-1 alpha protein stability and function. Diabetes. 2004;53(12):3226-32. https://doi.org/10.2337/diabetes.53.12.3226

[22] Ramirez J, Aliberti S, Mirsaeidi M, Peyrani P, Filardo G, Amir A, Moffett B, Gordon J, Blasi F, Bordon J. Acute myocardial infarction in hospitalized patients with community-acquired pneumonia. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America. 2008;47(2):182-7. https://doi.org/10.1086/589246

[23] Reade MC, Weissfeld L, Angus DC, Kellum JA, Milbrandt EB. The prevalence of anemia and its association with 90-day mortality in hospitalized community-acquired pneumonia. BMC pulmonary medicine. 2010;10:15. https://doi.org/10.1186/1471-2466-10-15

[24] Viasus D, Garcia-Vidal C, Simonetti A, Manresa F, Dorca J, Gudiol F, Carratalà J. Prognostic value of serum albumin levels in hospitalized adults with community-acquired pneumonia. The Journal of Infection. 2013;66(5):415-23. https://doi.org/10.1016/j.jinf.2012.12.007

[25] Ugajin M, Yamaki K, Iwamura N, Yagi T, Asano T. Blood urea nitrogen to serum albumin ratio independently predicts mortality and severity of community-acquired pneumonia. International journal of general medicine. 2012;5:583-9. https://doi.org/10.2147/IJGM.S33628

[26] Irfan M, Hussain SF, Mapara K, Memon S, Mogri M, Bana M, Malik A, Khan S, Khan NA. Community-acquired pneumonia: risk factors associated with mortality in tertiary care hospitalized patients. JPMA The Journal of the Pakistan Medical Association. 2009;59(7):448-52.

[27] Melzer M, Petersen I. Mortality following bacteraemic infection caused by extended spectrum beta-lactamase (ESBL) producing E. coli compared to non-ESBL producing E. coli. The Journal of infection. 2007;55(3):254-9. https://doi.org/10.1016/j.jinf.2007.04.007

[28] Harris AD, McGregor JC, Johnson JA, Strauss SM, Moore AC, Standiford HC, Hebden JN, Morris JG Jr. Risk factors for colonization with extended-spectrum beta-lactamase-producing bacteria and intensive care unit admission. Emerging infectious diseases. 2007;13(8):1144-9. https://doi.org/10.3201/eid1308.070071

[29] Schwaber MJ, Carmeli Y. The effect of antimicrobial resistance on patient outcomes: importance of proper evaluation of appropriate therapy. Critical care. 2009;13(1):106. https://doi.org/10.1186/cc7136

[30] Houck PM, Bratzler DW, Nsa W, Ma A, Bartlett JG. Timing of antibiotic administration and outcomes for Medicare patients hospitalized with community-acquired pneumonia. Archives of internal medicine. 2004;164(6):637-44. https://doi.org/10.1001/archinte.164.6.637

[31] Abisheganaden J, Ding YY, Chong WF, Heng BH, Lim TK. Predicting mortality among older adults hospitalized for community-acquired pneumonia: an enhanced confusion, urea, respiratory rate, and blood pressure score compared with the pneumonia severity index. Respirology. 2012;17(6):969-75. https://doi.org/10.1111/j.1440-1843.2012.02183.x

[32] Hwazenamerabdalnabi, J., Jasimm, A., Altameme Molecular screening of E. colibiofilm and anantibiofilm activity of Capparisspinosa L extracts. (2018) International Journal of Pharmaceutical Research, 10 (4), pp. 528-532. https://www.scopus.com/inward/record.uri?eid=2-s2.0-

85062385455&doi=10.31838%2fijpr%2f2018.10.04.105&partnerID=40&md5=6b066b3c50a5b76c142f205fd7e85b08

[33] K, m. S. K., alias, . M. & r. S. K. (2018), a review on novel uses of vitamin E. Journal of Critical Reviews, 5 (2), 10-14. doi:10.22159/jcr.2018v5i2.24282

[34] Ghosh A, Ghosh T. "Herbal Drugs of Abuse." Systematic Reviews in Pharmacy 1.2 (2010), 141-145. Print. doi:10.4103/0975-8453.75060

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Published

30.04.2020

How to Cite

Handriyani, & Wulandari, L. (2020). Correlation between Clinical Prognostic Factors and CAP Patients’ Output due to Klebsiella Pneumoniae. International Journal of Psychosocial Rehabilitation, 24(2), 4122-4131. https://doi.org/10.61841/dvvynr20