Clinical and microbiological characteristics of community-acquired thoracic empyema or complicated parapneumonic effusion caused by Klebsiella pneumoniae in Taiwan
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Klebsiella pneumoniae is the major cause of community-acquired pyogenic infections in Taiwan and is becoming an increasing problem in acute thoracic empyema. This study evaluated the clinical and microbiological characteristics of community-acquired thoracic empyema or complicated parapneumonic effusion caused by K. pneumoniae in Taiwanese adults treated during the period 2001–2008 at a tertiary medical center. All clinical isolates were examined for capsular serotypes K1/K2, and pulsed-field gel electrophoresis (PFGE) was performed on strains of the same serotype. K. pneumoniae was the most frequent cause of community-acquired thoracic empyema or complicated parapneumonic effusion. It was associated with high mortality (32.4%) and was an independent risk factor for fatal outcome. Diabetes mellitus, liver cirrhosis, and bronchogenic carcinoma were independent risk factors for K. pneumoniae infection. Serotypes K1 (9/37, 24.3%) and K2 (13/37, 35.1%) were the prevalent strains but did not predispose patients to poor outcome compared with other non-K1/K2 serotypes. There was no major cluster of isolates found among serotype K1/K2 strains. In summary, physicians should be aware of the risk factors for thoracic empyema or complicated parapneumonic effusion caused by K. pneumoniae and the associated high mortality, and monitor these patients more closely.
KeywordsLiver Abscess Pleural Fluid Bronchogenic Carcinoma Tertiary Medical Center Pyogenic Infection
This study was supported by grants V99A-143 and V99C1-115 from Taipei Veterans General Hospital.
Conflict of interest
All authors report no conflicts of interest.
- 7.Clinical and Laboratory Standards Institute (2007) Performance standards for antimicrobial susceptibility testing. 17th informational supplement. CLSI document M100-S17. Clinical and Laboratory Standards Institute, Wayne, PAGoogle Scholar
- 12.Ko WC, Paterson DL, Sagnimeni AJ, Hansen DS, Von Gottberg A, Mohapatra S, Casellas JM, Goossens H, Mulazimoglu L, Trenholme G, Klugman KP, McCormack JG, Yu VL (2002) Community-acquired Klebsiella pneumoniae bacteremia: global differences in clinical patterns. Emerg Infect Dis 8:160–166CrossRefPubMedGoogle Scholar
- 20.Cheng DL, Liu YC, Yen MY, Liu CY, Wang RS (1991) Septic metastatic lesions of pyogenic liver abscess. Their association with Klebsiella pneumoniae bacteremia in diabetic patients Arch Intern Med 151:1557–1559Google Scholar
- 24.Tang HL, Chiang MK, Liou WJ, Chen YT, Peng HL, Chiou CS, Liu KS, Lu MC, Tung KC, Lai YC (2010) Correlation between Klebsiella pneumoniae carrying pLVPK-derived loci and abscess formation. Eur J Clin Microbiol Infect Dis 29(6):689–698Google Scholar