Abstract
BackgroundKlebsiella species are among the most common causes of bloodstream infection (BSI). However, few studies have evaluated their epidemiology in non-selected populations. The objective was to define the incidence of, risk factors for, and outcomes from Klebsiella species BSI among residents of the western interior of British Columbia, Canada.MethodsPopulation-based surveillance was conducted between April 1, 2010 and March 31, 2017.Results151 episodes were identified for an incidence of 12.1 per 100,000 population per year; the incidences of K. pneumoniae and K. oxytoca were 9.1 and 2.9 per 100,000 per year, respectively. Overall 24 (16%) were hospital-onset, 90 (60%) were healthcare-associated, and 37 (25%) were community-associated. The median patient age was 71.4 (interquartile range, 58.8–80.9) years and 88 (58%) cases were males. Episodes were uncommon among patients aged < 40 years old and no cases were observed among those aged < 10 years. A number of co-morbid medical illnesses were identified as significant risks and included (incidence rate ratio; 95% confidence interval) cerebrovascular accident (5.9; 3.3–9.9), renal disease 4.3; 2.5–7.0), cancer (3.8; 2.6–5.5), congestive heart failure (3.5; 1.6–6.6), dementia (2.9; 1.5–5.2), diabetes mellitus (2.6; 1.7–3.9), and chronic obstructive pulmonary disease (2.3; 1.5–3.5). Of the 141 (93%) patients admitted to hospital, the median hospital length stay was 8 days (interquartile range, 4–17). The in-hospital and 30-day all cause case-fatality rates were 24/141 (17%) and 27/151 (18%), respectively.ConclusionsKlebsiella species BSI is associated with a significant burden of illness particularly among those with chronic co-morbid illnesses.
Highlights
Klebsiella species are among the most common causes of bloodstream infection (BSI)
The regional microbiology laboratory at the Royal Inland Hospital in Kamloops identified all residents in the selected area with Klebsiella species BSI
Eleven patients had a second and one patient had a third episode of Klebsiella species BSI during the surveillance period
Summary
Klebsiella species are among the most common causes of bloodstream infection (BSI). Few studies have evaluated their epidemiology in non-selected populations. The objective was to define the incidence of, risk factors for, and outcomes from Klebsiella species BSI among residents of the western interior of British Columbia, Canada. Klebsiella pneumoniae is second to Escherichia coli as the most frequent cause of Gram-negative bloodstream infections (BSI) in both hospital and community settings [1]. To our knowledge only three previous studies have evaluated Klebsiella species BSI in non-selected populations [1, 13, 14]. The objective of this study was to determine the incidence and risk factors for acquiring Klebsiella species BSI among residents of a non-selected Canadian population
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