Factors related to adverse outcomes in Klebsiella Pneumoniae Bacteremia
Factores relacionados con desenlaces adversos en bacteriemia por Klebsiella Pneumoniae
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Objective: Relate demographic, clinical and therapeutic factors with adverse outcomes in patients over 18 years of age with Klebsiella pneumoniae bacteremia in a level III Hospital in the city of Manizales
Methods: An observational, retrospective study was conducted in which 79 patients were selected from a hospital in the city of Manizales between January 2017 and December 2018. Data analyzed included demographic, clinical, therapeutic and adverse outcomes. A bivariate analysis was made with the statistical package SPSS STATISTICS Version 22.
Results: 62% of the patients were male, the average age was 58 years. 46% of the patients were in the ICU at the time of diagnosis. 73.4% underwent some type of surgical procedure. 75.8% received at least one antibiotic and 89.9% had invasive devices before the diagnosis of bacteremia. 67.1% required some type of support due to organic dysfunction. 72.2% were admitted to the ICU, 74.7% had sepsis, 48.1% septic shock, 59.5% needed mechanical ventilation, 67.1 % needed Inotropic or vasopressor support and 15.2% renal replacement therapy; an in-hospital mortality rate of 38% was found. The study found factors against negative outcomes for patients aged less than 60 years, lactate less than 4 mmol/l, use of targeted treatment, monotherapy with meropenem and APACHE less than 15. On the other hand the use of a bladder catheter and central venous catheter, being of female sex, a history of recent surgery, serum albumin less than 2 mg / dl and comorbidities such as heart failure and diabetes mellitus were risk factors that produced worse outcomes.
Conclusions: Klebsiella pneumoniae bacteremia generates adverse outcomes, including long hospital stays and high mortality. There are also other factors that may be related to this presentation, so further prospective and multicenter studies that address this issues will be required.
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