A Comparative Study of Community-acquired Klebsiella pneumoniae Bacteremia and Escherichia coli Bacteremia

Abstract

Background : Klebsiella pneumoniae is the second most common causative pathogen only

nest to Escherichia coli among the facultative Gram-negative rods causing both

community-acquired and nosocomial bacteremia.

Methods : We have reviewed the clinical and laboratory data from all patients with

community-acquired K. pneumoniae bacteremia and compared it with randomly selected

community-acquired. E. coli bacteremia in the patients who were admitted to Ajou University Hospital between the period from 1997 to 1998.

Results : The incidence of K. pneumoniae bacteremia was 1.8/1,000 patient discharge. Of 51 patients with K. pneumoniae bacteremia, 27 were male and 24 were female. The mean age was 58.4 years. The primary foci of K. pneumoniae bacteremia were hepatobiliary tract (35%), urinary tract (22%), respiratory tract (16%) and 20% of patients had no primary focus identified. The atrtributable mortality of K. pneumoniae bacteremia was 20%. Patients with K.

pneumoniae and E. coli bacteremia had common clinical features, but K. pneumoniae

bacteremia had high incidence of diabetes mellitus as an underlying illness and there was a tendency to form abscess and neutropenia more frequently than in E. coli bacteremia. E. coli was found to be more resistant to antibiotics (ampicillin/sulbactam, ciprofloxacin, gentamicin, cephalothin, cotrimoxazole, tetracycline and tobramycin) than K. pneumoniae.

Conclusion : K. pneumoniae bacteremia occurred more frequently in diabetes mellitus and the major primary focus was hepatobiliary tract. K. pneumoniae bacteremia had a higher incidence of abscess formation and neutropenia than E. coli.