Skip to main content

Advertisement

SpringerLink
Log in

Haematogenous Klebsiella pneumoniae osteomyelitis

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Objectives

Klebsiella pneumoniae infection has been associated with alcoholic and diabetic patient populations, especially in Asian populations. K. pneumonia wound infection is common, but K. pneumonia without wound osteomyelitis (OM) is relatively rare. However, the pathogenesis of haematogenous K. pneumonia without open wound OM still unclear until now. In our research, we are trying to collect patients with haematogenous K. pneumonia osteomyelitis (K.p OM) at our hospital and to evaluate their contributing factors.

Methods

We compiled a retrospective database of haematogenous K. pneumonia osteomyelitis (K.p OM) from 1990 to 2019 at our hospital. Patients’ bone cultures without K. pneumonia infection were excluded. Sixteen patients with haematogenous K.p OM were recruited. Patients’ basic information, comorbidities, wound history, the biochemical examination of the blood, bacterial blood, bone, urine, and liver abscess cultures, the location of OM, corresponding treatments, and post operation K.p wound infection history were reviewed retrospectively. The collected data were analyzed using SPSS software.

Results

Unwounded haematogenous K.p OM had a statistically significant and positive correlation with liver insufficiency (P = .037; OR = 2.200), advanced age (≥ 65 years) (P = .037; OR = 2.200) and male gender (P = .03; OR = 1.833). DM, hypertension, steroid usage, GI or GU tract K.p infection, post operation K.p wound infection, hypoalbuminemia, and the location of K.p OM had no significant relationship to outcomes.

Conclusion

Male patients of advanced age (> 65 years) and patients with liver insufficiency, including liver cirrhosis and hepatitis, have a strong correlation with unwounded haematogenous K.p OM.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Del Pozo JL, Patel R (2009) Clinical practice Infection associated with prosthetic joints. N Engl J Med 361(8):787–94

    Article  Google Scholar 

  2. Carvalho VC, Oliveira PR, Dal-Paz K, Paula AP, Felix Cda S, Lima AL (2012) Gram-negative osteomyelitis clinical and microbiological profile. Braz J Infect Dis 16(1):63–67

    PubMed  Google Scholar 

  3. Ko WC, Paterson DL, Sagnimeni AJ, Hansen DS, Von Gottberg A, Mohapatra S et al (2002) Community-acquired Klebsiella pneumoniae bacteremia global differences in clinical patterns. Emerg Infect Dis 8(2):160–166

    Article  Google Scholar 

  4. Huang CH, Tsai JS, Chen IW, Hsu BR, Huang MJ, Huang YY (2015) Risk factors for in-hospital mortality in patients with type 2 diabetes complicated by community-acquired Klebsiella pneumoniae bacteremia. J Formos Med Assoc 114(10):916–922

    Article  Google Scholar 

  5. Paczosa MK, Mecsas J (2016) Klebsiella pneumoniae: going on the offense with a strong defense. Microbiol Mol Biol Rev 80(3):629–661

    Article  CAS  Google Scholar 

  6. Ashurst JV, Dawson A. (2020) Klebsiella pneumonia. StatPearls. Treasure Island (FL).

  7. Meddings L, Myers RP, Hubbard J, Shaheen AA, Laupland KB, Dixon E et al (2010) A population-based study of pyogenic liver abscesses in the United States incidence, mortality, and temporal trends. Am J Gastroenterol 105(1):117–124

    Article  Google Scholar 

  8. Mustapic M, Viskovic K, Boric I, Marjan D, Zadravec D, Begovac J (2016) Vertebral osteomyelitis in adult patients–characteristics and outcome. Acta Clin Croat 55(1):9–15

    Article  Google Scholar 

  9. Keller JJ, Tsai MC, Lin CC, Lin YC, Lin HC (2013) Risk of infections subsequent to pyogenic liver abscess: a nationwide population-based study. Clin Microbiol Infect 19(8):717–722

    Article  CAS  Google Scholar 

  10. Hanley ME, Cooper JS. (2020) Hyperbaric, chronic refractory osteomyelitis. StatPearls. Treasure Island (FL)

  11. Lam G, Fontaine R, Ross FL, Chiu ES (2017) Hyperbaric oxygen therapy: exploring the clinical evidence. Adv Skin Wound Care 30(4):181–190

    Article  Google Scholar 

  12. Hopf HW, Holm J (2008) Hyperoxia and infection. Best Pract Res Clin Anaesthesiol 22(3):553–569

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, Republic of China

    Hsin-I. Chien, Kuo-Chung Yang, Wen-Chung Liu, Yen-Yi Ho, Wei-Hsuan Tsai & Lee-Wei Chen

  2. National Yang Ming Chiao Tung University, 386, Da-Zhong 1st Rd., Kaohsiung, Taipei, Taiwan, Republic of China

    Kuo-Chung Yang, Wen-Chung Liu & Lee-Wei Chen

Authors
  1. Hsin-I. Chien
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kuo-Chung Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wen-Chung Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yen-Yi Ho
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Wei-Hsuan Tsai
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lee-Wei Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lee-Wei Chen.

Ethics declarations

Ethics approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chien, HI., Yang, KC., Liu, WC. et al. Haematogenous Klebsiella pneumoniae osteomyelitis. International Orthopaedics (SICOT) 45, 1693–1698 (2021). https://doi.org/10.1007/s00264-021-05072-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-021-05072-8

Keywords

Search

Navigation