title: Bacteremic community-acquired infections due to Klebsiella pneumoniae: clinical and microbiological presentation in New Caledonia, 2008-2013.
abstract: OBJECTIVE
  To provide data on severe bacteremic community-acquired infections due to Klebsiella pneumoniae in New Caledonia.
  
  
  METHODS
  All patients admitted with bacteremic community-acquired infections due to K. pneumoniae at the only tertiary medical center in New Caledonia, from 2008 to 2013, were included retrospectively in this study. Clinical and microbiological characteristics were analyzed, as well as risk factors for mortality.
  
  
  RESULTS
  The characteristics of 119 patients were analyzed. The most common clinical presentation was urinary tract infection (40 cases, 33%), followed by pneumonia (28 cases, 23%), deep abscesses (15 cases, 13%), liver abscess (12 cases, 9%), meningitis in (five cases, 4%), and endophthalmitis (two cases, 1%). Multiple localizations were reported in 18 cases (15%) and isolated bacteremia was reported in 22 cases (18%). The overall mortality rate was 22% (26/119) and the mortality rate in the intensive care unit was 33% (14/42). Renal impairment, chronic liver disease, pneumonia, and isolated bacteremia were independent risk factors for mortality.
  
  
  CONCLUSIONS
  K. pneumoniae is a dominant cause of severe community-acquired bacteremic infection in New Caledonia. Physicians should be aware of the poor prognosis of any patient with a bacteremic K. pneumoniae infection and should monitor patients presenting with risk factors closely.
authors.affiliation: Institut Pasteur in New Caledonia, Microbiology Laboratory, Noumea, New Caledonia.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Melot
authors.affiliation: Institut Pasteur in New Caledonia, Microbiology Laboratory, Noumea, New Caledonia.
authors.forename: Julien
authors.initials: J
authors.lastname: Colot
authors.affiliation: Intensive Care Unit, Centre Hospitalier Territorial, Noumea, New Caledonia; Anaesthetic and Intensive Care Department, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France. Electronic address: guerriergilles@gmail.com.
authors.forename: Gilles
authors.initials: G
authors.lastname: Guerrier
mesh_terms: D016470:Bacteremia / Q000382:microbiology; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology*; D009877:Endophthalmitis / Q000382:microbiology; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000453:epidemiology* / Q000382:microbiology*; D007711:Klebsiella pneumoniae; D008100:Liver Abscess / Q000382:microbiology; D008297:Male; D009510:New Caledonia / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Community-acquired bacteremia; Klebsiella pneumoniae; Mortality; New Caledonia