Hospital Outcomes of Adult Respiratory Tract Infections with Extended-Spectrum B-Lactamase (ESBL) Producing Klebsiella Pneumoniae
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Abstract
Klebsiella pneumoniae ranks high as a cause of adult pneumonia requiring hospitalization in Malaysia. To study whether extended-spectrum b-lactamase (ESBL) producing K. pneumoniae was linked to hospital outcomes, we retrospectively studied 441 cases of adult respiratory tract infections with microbial proven K. pneumoniae from an urban-based university teaching hospital between 2003 and 2004. 47 (10.6%) cases had ESBL. Requirement for ventilation and median length of hospital stay, were greater in ‘ESBL’ than in ‘non-ESBL’ group [34% vs. 7.4%, p<0.001; 14 days vs. 5 days, p<0.001 respectively] but not crude hospital mortality rate [21.3% vs. 12.4%, p=0.092]. There was a four-fold increased risk of requiring ventilation [4.61 (2.72-7.85)] when ESBL was present. Our findings support the association of ESBL producing K. pneumoniae with adversed hospital outcomes and reiterate the need for vigilance on the part of treating clinicians.
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References
Toner, M., and Irimia, D. Blood-on-a-chip Annual Review of Biomedical Engineering 2005; 7:77–103.
Boyum, A. Isolation of leucocytes from human blood: A two-phase system for removal of red cells with
methylcellulose as erythrocytes aggregative agent Scandinavian Journal of Clinical and Laboratory
Investigation 1968; 21:9–29.
Boyum, A. Isolation of leucocytes from human blood: Further observations – methylcellulose, dextran and
Ficoll as erythrocyte aggregating agents Scandinavian Journal of Clinical and Laboratory Investigation 1968;
:50.
Tiirikainen, MI. Evaluation of red blood cell lysing solutions for the detection of intracellular antigens by
flow cytometry Cytometry 1995; 20: 341 – 348.
Gaudernack, T., Leivestad, T., Ugelstad, J. and Thorsby, E. Isolation of pure functionally active CD8+ T cells.
Positive selection with monoclonal antibodies directly conjugated to monosized magnetic microspheres
Journal of Immunological Methods 1986; 90:179–187.
Olsvik, Ø., Popovic, T., Skjerve, E., Cudjoe, KS., Hornes, E., Ugelstad, J. and Uhlén, M. Magnetic separation techniques in diagnostic microbiology Clinical Microbiology Review 1994; 7:43–54.
Molnar, B., Sipos, F., Galamb, O. and Tulassay, Z. Molecular detection of circulating cancer cells Digestive Diseases 2003; 21:320–325.
Hayflick, L. and Moorhead, PS. The serial cultivation of human diploid cell strains Experimental Cell Research 1961; 25:585–621.
Bodnar, AG., Ouellette, M., Frolkis, M., Holt, SE., Chiu, C-P., Morin, GB., Harley, CB., Shay, JW., Lichsteiner, S. and Wright, WE. Extension of life-span by introduction of telomerase into normal human cells
Science 1998; 279:349–352.
Mosmann, S. Rapid colorimetric assay for cellular growth and survival: application to proliferation and cytotoxicity assays Journal of Immunological Methods 1983; 65:55–63.
Mizuki E, Ohba M, Akao T, Yamashita S, Saitoh H and Park YS. Unique activity associated with noninsecticidal Bacillus thuringiensis parasporal inclusions: in vitro cell-killing action on human cancer
cells Journal of Applied Microbiology 1999; 86:477–486.
Mizuki E, Park YS, Saitoh H, Yamashita S, Akao T, Higuchi K and Ohba M. Parasporin, a human leukemic cell-recognizing parasporal protein of Bacillus thuringiensis Clinical Diagnostic and Laboratory Immunology 2000; 7:625–634.
Nadarajah, VD., Chai, SH. Diana T, Mohamed, SM, Michelle NYT, Kumaresan S. The bioactivity of Bacillus thuringiensis - diversity in the Malaysian strains Proceedings of the 14th National Biotechnology
Seminar 2003; 243–248.
Toivanen, P. and Toivanen, A. Selective activation of chicken T lymphocytes by concanavalin A Journal of
Immunology 1973; 111: 1602–0606.
Loa, CC, Lin, TL. and Wu, CC. Factors affecting mitogenic response of turkey lymphocytes Acta Veterinary Brno 2001; 70: 433–442. [* PICT is empty or cannot be processed. | In-line Graphic *]