Clinical Characteristics and Prognosis of Hospital-Acquired Klebsiella pneumoniae Bacteremic Pneumonia versus Escherichia coli Bacteremic Pneumonia: A Retrospective Comparative Study
Fuxing Li, Junqi Zhu, Yaping Hang, Yanhui Chen, Shumin Gu, Suqin Peng, Youling Fang, Longhua Hu, Jianqiu Xiong
Abstract
Objective: This research aimed to investigate the variations in clinical features and prognosis of HABP caused by E. coli and K. pneumoniae . We also aimed to evaluate the risk variables related to 30-day death in the investigated groups. Methods: A single-center retrospective cohort research lasting four years was performed. A total of 117 patients with HABP were involved in this research. The primary prognosis was 30-day death. Results: Among 117 patients with HABP, 60 patients were infected with K. pneumoniae (KP-HABP), and 57 patients were infected with E. coli (E. coli-HABP). A higher proportion of males, ICU admission, undergoing tracheotomy and trachea cannulation, carbapenem-resistant strains, inappropriate empirical therapy (IET), immune compromise, diabetes mellitus, and sepsis were observed in the patients with KP-HABP (all P < 0.05). Meanwhile, the median SOFA score and Pitt score were significantly ( P < 0.001) higher in the KP-HABP group compared to the E. coli-HABP group. The 30-day death was 48.33% in the KP-HABP group and 24.56% in the E. coli-HABP group ( P = 0.008). After adjusting for the main covariates, the hazard ratios for 30-day mortality in KP-HABP were 1.58 (95% CI:0.80– 3.12), 3.24 (95% CI:1.48– 7.06), 5.67 (95% CI:2.00– 16.07), and 5.99 (95% CI:2.10– 17.06), respectively. Multivariate logistic regression models revealed that IET, hypoproteinaemia, cerebral vascular disease (CVD), and SOFA score ≥ 5.0 were the independent risk variables for 30-day death in KP-HABP. Simultaneously, SOFA score ≥ 4.0 and Pitt score ≥ 2.0 were independent risk factors for 30-day mortality in E. coli-HABP. Conclusion: The clinical features of HABP vary depending on whether it is caused by Escherichia coli or K. pneumoniae . KP-HABP patients have higher 30-day mortality than E. coli-HABP patients. To ensure greater validity, it is necessary to further verify this conclusion using a larger sample size. Keywords: Escherichia coli , Klebsiella pneumoniae , hospital-acquired pneumonia, bacteremic pneumonia, 30-day mortality