title: Klebsiella infection in patients with thalassemia.
abstract: Klebsiella infection has previously been reported in a few patients with transfusion-dependent thalassemia. The incidence and clinical spectrum of this infection in our cohort of patients were reviewed retrospectively. Among 160 patients observed for 12 years, there were 15 episodes of Klebsiella infection that occurred in 12 patients (7.5%), resulting in an incidence of 0.78 infections per 100 patient-years. The clinical spectrum included sinusitis (4 cases), intracranial infection (5 cases), septicemia (4 cases), and abscesses of the liver, lung, kidney, and parotid gland (1 case each). Three patients had recurrent infections involving different sites, 2 (16%) died of fulminant septicemia, and 3 (25%) had significant permanent neurological deficits. The antibiotic susceptibility pattern for the isolates was similar to the pattern for isolates recovered in the community. With regard to predisposing factors, iron overload and liver function derangement were found to be significant on univariate analysis (P=.046 and P=.049, respectively) but insignificant on multivariate analysis. Klebsiella infection was a serious and frequently encountered complication in our patients with transfusion-dependent thalassemia, resulting in high mortality and morbidity rates.
authors.affiliation: Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China.
authors.forename: B H Y
authors.initials: BH
authors.lastname: Chung
authors.forename: S Y
authors.initials: SY
authors.lastname: Ha
authors.forename: G C F
authors.initials: GC
authors.lastname: Chan
authors.forename: A
authors.initials: A
authors.lastname: Chiang
authors.forename: T L
authors.initials: TL
authors.lastname: Lee
authors.forename: H K
authors.initials: HK
authors.lastname: Ho
authors.forename: C Y
authors.initials: CY
authors.lastname: Lee
authors.forename: C W
authors.initials: CW
authors.lastname: Luk
authors.forename: Y L
authors.initials: YL
authors.lastname: Lau
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007710:Klebsiella Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D007711:Klebsiella pneumoniae / Q000187:drug effects; D008297:Male; D008826:Microbial Sensitivity Tests; D012189:Retrospective Studies; D012307:Risk Factors; D013789:Thalassemia / Q000150:complications*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents