Comparison between Patients with Chest Infection due to Klebsiella spp. and Streptococcus pneumoniae

• Published in: Internal Medicine Vol. 59; no. 5; pp. 611 - 618
• Main Authors: Ishiguro, Takashi, Uozumi, Ryuji, Yoshioka, Hiroaki, Nishida, Takashi, Takayanagi, Noboru
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.03.2020; Japan Science and Technology Agency
• Subjects: Abscesses; Age Factors; Aged; Aged, 80 and over; Aging; Antibiotics; Chest; Coinfection; Comorbidity; Cross Infection - epidemiology; Cross Infection - microbiology; Diabetes mellitus; Drinking behavior; Empyema; Empyema - epidemiology; Empyema - microbiology; Female; Health Status; Humans; Internal medicine; Japan; Klebsiella; Klebsiella Infections - epidemiology; Klebsiella Infections - pathology; Klebsiella pneumoniae; lung abscess; Lung Abscess - epidemiology; Lung Abscess - microbiology; Lung Diseases - epidemiology; Lung Diseases - microbiology; Lung Diseases - pathology; Male; Males; Middle Aged; necrotizing pneumonia; Original; Patients; Pneumococcal Infections - epidemiology; Pneumococcal Infections - pathology; Pneumonia; Pneumonia - epidemiology; Pneumonia - microbiology; pulmonary gangrene; Retrospective Studies; Sex Factors; Streptococcus infections; Streptococcus pneumoniae; Surgery; Japan; lung abscess; necrotizing pneumonia; pulmonary gangrene; Klebsiella pneumoniae; Streptococcus pneumoniae
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.3531-19

Objective In Japan, the aging demographic structure is becoming pronounced, and the full-blown graying of society appears not far off, which indicates an increasing population that will require healthcare contact. Klebsiella spp. are major pathogens in healthcare-associated infections, and their importance is increasing. The aim of this study was to clarify the characteristics of Klebsiella spp. chest infections by evaluating the differences in the characteristics of chest infections caused by Klebsiella spp. and pneumoniae. Methods We conducted a retrospective study of consecutive patients hospitalized with pneumonia, lung abscess/necrotizing pneumonia, and empyema due to Klebsiella spp. and S. pneumoniae for 15 years at our institution in Saitama, Japan. Patients Patients with chest infections due to Klebsiella spp. (K group, n=76) and S. pneumoniae (S group, n=446) were included. Results The K group more frequently was male, older, coinfected by Pseudomonas aeruginosa, and had diabetes mellitus, a history of upper digestive system surgery, alcohol drinking habit, a smoking habit, and an impaired premorbid performance status than the S group. The percentages of lung abscesses or necrotizing pneumonia (31.6% vs. 0.9%) and empyema without pulmonary parenchymal shadow (3.9% vs. 0.7%) were higher in the K group than those in the S group. Severity on admission and mortality did not differ between the groups; however, patients in the K group required a longer duration of antibiotics administration and hospital stay than those in the S group. Conclusion Klebsiella spp. chest infections have some marked characteristics when compared with pneumococcal infections, and our results serve to differentiate Klebsiella spp. infection from pneumococcal infection.