title: Klebsiella pneumoniae oropharyngeal carriage in rural and urban Vietnam and the effect of alcohol consumption.
abstract: BACKGROUND
  Community acquired K. pneumoniae pneumonia is still common in Asia and is reportedly associated with alcohol use. Oropharyngeal carriage of K. pneumoniae could potentially play a role in the pathogenesis of K. pneumoniae pneumonia. However, little is known regarding K. pneumoniae oropharyngeal carriage rates and risk factors. This population-based cross-sectional study explores the association of a variety of demographic and socioeconomic factors, as well as alcohol consumption with oropharyngeal carriage of K. pneumoniae in Vietnam.
  
  
  RESULTS
  1029 subjects were selected randomly from age, sex, and urban and rural strata. An additional 613 adult men from a rural environment were recruited and analyzed separately to determine the effects of alcohol consumption. Demographic, socioeconomic, and oropharyngeal carriage data was acquired for each subject. The overall carriage rate of K. pneumoniae was 14.1% (145/1029, 95% CI 12.0%-16.2%). By stepwise logistic regression, K. pneumoniae carriage was found to be independently associated with age (OR 1.03, 95% CI 1.02-1.04), smoking (OR 1.9, 95% CI 1.3-2.9), rural living location (OR 1.6, 95% CI 1.1-2.4), and level of weekly alcohol consumption (OR 1.7, 95% CI 1.04-2.8).
  
  
  CONCLUSIONS
  Moderate to heavy weekly alcohol consumption, old age, smoking, and living in a rural location are all found to be associated with an increased risk of K. pneumoniae carriage in Vietnamese communities. Whether K. pneumoniae carriage is a risk factor for pneumonia needs to be elucidated.
authors.affiliation: National Hospital for Tropical Diseases, Hanoi, Viet Nam.
authors.forename: Trinh Tuyet
authors.initials: TT
authors.lastname: Dao
authors.affiliation: Oxford University Clinical Research Unit, Hanoi, Viet Nam.
authors.forename: Dror
authors.initials: D
authors.lastname: Liebenthal
authors.affiliation: Hanoi Medical University, Hanoi, Vietnam.
authors.forename: Toan Khanh
authors.initials: TK
authors.lastname: Tran
authors.affiliation: Oxford University Clinical Research Unit, Hanoi, Viet Nam.
authors.forename: Bich
authors.initials: B
authors.lastname: Ngoc Thi Vu
authors.affiliation: Oxford University Clinical Research Unit, Hanoi, Viet Nam.
authors.forename: Diep
authors.initials: D
authors.lastname: Ngoc Thi Nguyen
authors.affiliation: Oxford University Clinical Research Unit, Hanoi, Viet Nam.
authors.forename: Huong Kieu
authors.initials: HK
authors.lastname: Thi Tran
authors.affiliation: Hanoi Medical University, Hanoi, Vietnam.
authors.forename: Chuc Kim
authors.initials: CK
authors.lastname: Thi Nguyen
authors.affiliation: Oxford University Clinical Research Unit, Hanoi, Viet Nam.
authors.forename: Huong Lan
authors.initials: HL
authors.lastname: Thi Vu
authors.affiliation: Oxford University Clinical Research Unit, Hanoi, Viet Nam; Nuffield Department of Clinical Medicine, Centre for Tropical Medicine, University of Oxford, Oxford, United Kingdom.
authors.forename: Annette
authors.initials: A
authors.lastname: Fox
authors.affiliation: Oxford University Clinical Research Unit, Hanoi, Viet Nam; Nuffield Department of Clinical Medicine, Centre for Tropical Medicine, University of Oxford, Oxford, United Kingdom.
authors.forename: Peter
authors.initials: P
authors.lastname: Horby
authors.affiliation: National Hospital for Tropical Diseases, Hanoi, Viet Nam.
authors.forename: Kinh
authors.initials: K
authors.lastname: Van Nguyen
authors.affiliation: Oxford University Clinical Research Unit, Hanoi, Viet Nam; Nuffield Department of Clinical Medicine, Centre for Tropical Medicine, University of Oxford, Oxford, United Kingdom.
authors.forename: Heiman F L
authors.initials: HF
authors.lastname: Wertheim
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects*; D002353:Carrier State; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007710:Klebsiella Infections / Q000453:epidemiology* / Q000209:etiology; D007711:Klebsiella pneumoniae / Q000302:isolation & purification*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009960:Oropharynx / Q000382:microbiology*; D011379:Prognosis; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*; D014744:Vietnam / Q000453:epidemiology; D055815:Young Adult