Klebsiella pneumoniae bacteraemia at an urban general hospital.
Of 47 patients with Klebsiella pneumoniae bacteraemia admitted to the Hillbrow Hospital, Johannesburg during a period of 18 months, 31 were males and 16 were females. Features predisposing to illness were found in 89.4% patients, chronic alcoholism, neoplastic disease and diabetes mellitus being the most common. Twenty-five infections were acquired in hospital and 22 in the community. Most patients (59.6%) had pneumonia. All isolates of K. pneumoniae were resistant to ampicillin (100%); several (42.6%) were resistant to other antibiotics also. The overall mortality rate was 55.3%. A higher mean initial blood pressure and lower concentrations of serum urea and bilirubin were found in survivors. None of the 28 patients, surviving more than 48 h who received combined therapy with an aminoglycoside and a beta-lactam antibiotic (to which the organism was susceptible) died. Among the remaining patients treated with either an appropriate beta-lactam agent alone, an appropriate aminoglycoside alone or ciprofloxacin the combined mortality rate was 83.3% (P = 0.007).
Department of Internal Medicine, Hillbrow Hospital, Johannesburg, South Africa.
C
C
Feldman
C
C
Smith
H
H
Levy
P
P
Ginsburg
S D
SD
Miller
H J
HJ
Koornhof
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015984:Causality; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D006769:Hospitals, General; D006786:Hospitals, Urban; D006801:Humans; D007710:Klebsiella Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D007711:Klebsiella pneumoniae; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018805:Sepsis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D013019:South Africa / Q000453:epidemiology
D000900:Anti-Bacterial Agents