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Clinical and Microbiological Characteristics of Klebsiella pneumoniae Co-Infections in Pulmonary Tuberculosis: A Retrospective Study.


ABSTRACT:

Background

Klebsiella pneumoniae (K. pneumoniae) is one of the most common pathogens leading to pulmonary tuberculosis (PTB) co-infection, but the data of co-infections is scarce. This research aimed to study the clinical and microbiological characteristics of K. pneumoniae co-infections in pulmonary tuberculosis cases.

Methods

Clinical manifestations and examination results of PTB cases co-infected by K. pneumoniae were retrospectively collected from the medical record database of a tertiary teaching hospital in China between November 2019 and October 2021. The K. pneumoniae strains isolated from the patients were sent for whole-genome sequencing. Statistical analyses were conducted using Stata v.14.0.

Results

A total of 80 strains were collected from 76 PTB patients with K. pneumoniae co-infections (two strains were isolated from each of the four patients at different time points), including 37 primary and 39 retreated TB cases. Among these, 29 (36.3%) of the K. pneumoniae isolates were extended-spectrum β-lactamase (ESBL)-producing strains, and seven (8.8%) were determined as carbapenem-resistant Enterobacteriaceae (CRE) strains. We found that patients in the multidrug resistance (MDR)-group received more respiratory support than the non-MDR group (40.6% vs 18.2%, P= 0.031) and possessed higher elevated C-reactive protein (62.6% vs 41.8%, P=0.008) and lower haemoglobin (87.5% vs 47.7%, P=0.001). We found that 80.3% (61/76) patients had lung lesions and 57.8% (44/76) patients were immunocompromised within one month. The most common K. pneumoniae strain sequence type was ST23 (15%), followed by ST15 (12.5%) and ST273 (7.5%). Among the strains, 26.25% were classically hypervirulent K1/K2 K. pneumoniae, and all carried salmochelin and rmpA.

Conclusion

This study demonstrated the important clinical features, phenotypic and genomic characteristics of isolated strains of PTB patients with K. pneumoniae co-infection. These data suggested a special attention for multidrug resistant K. pneumoniae infections with more obvious inflammatory responses which calls for more respiratory support and timely clinical management.

SUBMITTER: Liu J 

PROVIDER: S-EPMC10640825 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Publications

Clinical and Microbiological Characteristics of <i>Klebsiella pneumoniae</i> Co-Infections in Pulmonary Tuberculosis: A Retrospective Study.

Liu Jun J   Zhang Yi Y   Cai Jianpeng J   Shao Lingyun L   Jiang Xiufeng X   Yin Xiaohong X   Zhao Xinguo X   Wang Sen S  

Infection and drug resistance 20231108


<h4>Background</h4><i>Klebsiella pneumoniae (K. pneumoniae)</i> is one of the most common pathogens leading to pulmonary tuberculosis (PTB) co-infection, but the data of co-infections is scarce. This research aimed to study the clinical and microbiological characteristics of <i>K. pneumoniae</i> co-infections in pulmonary tuberculosis cases.<h4>Methods</h4>Clinical manifestations and examination results of PTB cases co-infected by <i>K. pneumoniae</i> were retrospectively collected from the medi  ...[more]

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