Klebsiella bacteraemia: a report of 101 cases from National University Hospital, Singapore

Abstract

One hundred and one cases of Klebsiella bacteraemia from the National University Hospital, Singapore, were reviewed retrospectively. There were 54 (53·5%) males and 47 (46·5%) females. Mean (± £se) age was 54 (± 2·4) years. Overall mortality was 26%. Nosocomial infections accounted for 20%. Underlying diabetes mellitus and malignancy were present in 36 and 26% respectively. The source of the bacteraemia was not known in 33% of cases, 17% had liver abscess, 29% had urinary tract infections, 9% had pneumonia, 10% had an abscess separate from the liver, and 3% had biliary sepsis. Elevated alkaline phosphatase (> 100 U-) was seen in all cases of liver abscess (sensitivity 100%, specificity 27%). Nonsurvivors had a significantly lower platelet count than survivors (104± 25 × 109/1 vs. 176 ± 15 × 109/1, unpaired t-test P < 0·05), and a platelet count of less than 150 × 109/1 was associated with a significantly higher mortality (37% vs. 11%, χ2 P < 0·01). Nosocomial infection was associated with 45% mortality, whereas community-acquired infection had a lower rate of 21%, this was not statistically significant. Seventy-eight per cent of these Klebsiella isolates were sensitive to gentamicin and cotrimoxazole, and 100% to imipenem. © 1994.