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Lai C, Ma Z, Luo Y, Gao Y, Wu Z, Zhang J, Xu W. Factors influencing mortality in intracranial infections caused by carbapenem-resistant Klebsiella Pneumoniae. Sci Rep 2024; 14:20670. [PMID: 39237686 PMCID: PMC11377438 DOI: 10.1038/s41598-024-71660-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 08/29/2024] [Indexed: 09/07/2024] Open
Abstract
It remains that intracranial infection has an alarming mortality and morbidity. Klebsiella pneumoniae (KP) have increasingly been isolated in ventriculitis and meningitis episodes. Intracranial infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) account for high mortality. To understand its clinical impact and related risk factors accurately are crucial in the management of bacterial intracranial infection. The retrospective study aimed to delineate the clinical risk of death from intracranial infection and analyze the risk factors. A total of 176 Klebsiella pneumoniae intracranial infectious patients were available to divide into CRKP group and carbapenem-susceptive Klebsiella Pneumoniae (CSKP) group. We performed survival analysis and estimate the time-varying effects of CRKP and CSKP infection on 30-day mortality. Infectious patients caused by CSKP was associated with lower mortality than CRKP group. The risk factors associated with death from intracranial infection caused by Klebsiella pneumoniae included SOFA scores, ventilator therapy, CRKP, and heart failure. Longer hospital stays are independently associated with lower mortality rates. Intracranial infection caused by CRKP was associated with excess mortality. Complex comorbidities mean higher mortality. Active supportive treatment is required for complicated patients with intracranial infections caused by carbapenem-resistant Klebsiella pneumoniae.
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Affiliation(s)
- Chengcheng Lai
- Department of General Practice, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Zijun Ma
- Department of General Practice, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Yonggang Luo
- Department of Neurosurgical Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
| | - Yuan Gao
- Department of Critical Care Medicine, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200127, China
| | - Zhuanghao Wu
- Department of Neurosurgical Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Jun Zhang
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450002, China
| | - Weiwei Xu
- Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
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Vaikutyte-Ramanauskiene R, Puslys T, Pukenyte E, Mickiene A. The first case of invasive S. suis infection in a human in Lithuania: Case report and literature review. IDCases 2024; 37:e02050. [PMID: 39220425 PMCID: PMC11363833 DOI: 10.1016/j.idcr.2024.e02050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/22/2024] [Accepted: 08/01/2024] [Indexed: 09/04/2024] Open
Abstract
Streptococcus suis is an emerging zoonotic pathogen that can cause infections in pigs and humans, usually after ingestion of raw pork meat or wound contamination. We report the first S. suis meningitis and sepsis case in a human in Lithuania. 51 y.o. man with no relevant comorbidities, but with a history of alcohol abuse was admitted to the emergency department due to new-onset tonic-clonic seizures. The patient became agitated, aggressive and hypotensive, later sensible contact was lost (GCS of 8 points). Blood tests and cerebrospinal fluid (CSF) analysis were consistent with bacterial meningitis, thus ceftriaxone and ampicillin were empirically started. S. suis, susceptible to penicillin and ceftriaxone, was identified in blood and CSF cultures. The patient recovered without any immediate significant sequels, but later developed cognitive impairment. The route of infection for our patient was not clear because he had no contact with pigs or raw pork, although he lived in the countryside, helped farmers with non-pig related work, had some scabs on his shins and ate home-cooked pork. The paper presents the case report and review of the literature.
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Affiliation(s)
- Roberta Vaikutyte-Ramanauskiene
- Department of Infectious Diseases, Lithuanian University of Health Sciences Kaunas Hospital, Baltijos str. 120, Kaunas LT-47144, Lithuania
| | - Tautvydas Puslys
- Department of Neurology, Lithuanian University of Health Sciences, Eivenių str. 2, Kaunas LT-50161, Lithuania
| | - Evelina Pukenyte
- Department of Infectious Diseases, Lithuanian University of Health Sciences Kaunas Hospital, Baltijos str. 120, Kaunas LT-47144, Lithuania
- Department of Infectious Diseases, Lithuanian University of Health Sciences, A.Mickevičiaus str. 9, Kaunas LT-44307, Lithuania
| | - Aukse Mickiene
- Department of Infectious Diseases, Lithuanian University of Health Sciences Kaunas Hospital, Baltijos str. 120, Kaunas LT-47144, Lithuania
- Department of Infectious Diseases, Lithuanian University of Health Sciences, A.Mickevičiaus str. 9, Kaunas LT-44307, Lithuania
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Chen D, Tang B, Li Y, Zheng K, Li X, Chen W, Gao F, Gao Y, Shi K. Characteristics and risk factors of bacterial meningitis caused by Streptococcus agalactiae, Streptococcus pneumoniae or Escherichia coli in Guangzhou China from 2015 to 2022. Front Cell Infect Microbiol 2023; 12:1092468. [PMID: 36699723 PMCID: PMC9869027 DOI: 10.3389/fcimb.2022.1092468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 12/13/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction Bacterial meningitis (BM) is an infectious disease with high morbidity and mortality rates in children. Although vaccination has improved prevention of BM, this severe disease continues to cause considerable harm to children across the globe. Several risk factors have been identified for BM, including immune status, age, and sex. However, additional patient and disease information is required in order to better understand the local characteristics, epidemiology and risk factors of BM. Methods Here, we collected information from 252 children with BM in the Guangzhou Women and Children Medical Centre medical record database infected with Streptococcus agalactiae, Streptococcus pneumoniae, or Escherichia coli between May 2015 and May 2022. Results The three pathogen infected BM cased showed distinct trends during the period, and distribution of three BM pathogens across age groups varied significantly. We reviewed the antimicrobial resistance patterns for each of the pathogens which may direct drug use in BM. Finally, we found blood WBC was a protective factor, while glucose levels in the CFS was risk factor, for the length of hospitalization. Discussion Collectively, this study provides multi-parameter characteristics of BM, and potentially guide the drug use.
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Affiliation(s)
- Danchun Chen
- Department of Neurology, Guangzhou Women and Children’s Medical Center, Guangzhou, China,Department of Pediatrics, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Benyu Tang
- Department of Pediatrics, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ying Li
- Department of Neurology, Guangzhou Women and Children’s Medical Center, Guangzhou, China
| | - Kelu Zheng
- Department of Neurology, Guangzhou Women and Children’s Medical Center, Guangzhou, China
| | - Xiaojing Li
- Department of Neurology, Guangzhou Women and Children’s Medical Center, Guangzhou, China
| | - Wenxiong Chen
- Department of Neurology, Guangzhou Women and Children’s Medical Center, Guangzhou, China
| | - Fei Gao
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou, China
| | - Yuanyuan Gao
- Department of Neurology, Guangzhou Women and Children’s Medical Center, Guangzhou, China
| | - Kaili Shi
- Department of Neurology, Guangzhou Women and Children’s Medical Center, Guangzhou, China,*Correspondence: Kaili Shi,
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Rollin G, Rossi B, Brisse S, Decré D, Leflon-Guibout V, Bert F, Hoffmann I, Decousser JW, Fantin B, Lefort A. Spontaneous and postsurgical/traumatic Klebsiella pneumoniae meningitis: two distinct clinico-microbiological entities. Int J Infect Dis 2021; 114:185-191. [PMID: 34767984 DOI: 10.1016/j.ijid.2021.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES To analyze and compare the characteristics and outcomes of spontaneous meningitis (SM) versus postsurgical/traumatic meningitis (PSTM) due to Klebsiella pneumoniae. METHODS A retrospective multicentric cohort study of all K. pneumoniae meningitis cases managed between January 2007 and May 2018 was carried out in seven university hospitals in the Paris area. The microbiological characteristics of 16 available K. pneumoniae isolates were further analyzed, and the genomes of seven of those isolated from SM were sequenced. RESULTS Among 35 cases, 10 were SM and 25 were PSTM. SM cases more severe than PSTM cases, with higher septic shock (p = 0.004) and in-hospital mortality rates (p = 0.004). In contrast, relapse occurred in five patients from the PSTM group versus no patients from the SM group. All K. pneumoniae strains recovered from SM but none of those recovered from PSTM displayed hypervirulent phenotypic (positive string test) and genotypic (genes corresponding to capsular serotypes K1 or K2; virulence genes rmpA and iutA) characteristics (p < 0.0001). PSTM tended to be more frequently polymicrobial (p = 0.08) and caused by an extended-spectrum β-lactamase producing strain (p = 0.08) than SM. CONCLUSIONS SM and PSTM are two entities differing both from a clinical and a microbiological standpoint. SM appears to be a more serious infection, induced by hypervirulent K. pneumoniae strains.
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Affiliation(s)
| | - Benjamin Rossi
- Internal Medicine, Hôpital Robert Ballanger, Aulnay-sous-Bois, France.
| | - Sylvain Brisse
- Biodiversity and Epidemiology of Bacterial Pathogens, Institut Pasteur, Paris, France.
| | - Dominique Decré
- Bacteriology Department, GH-Est Parisien, APHP, Paris, France, Sorbonne University, INSERM1135, Cimi team 2, Paris, France.
| | | | - Frédéric Bert
- Bacteriology Department, Hôpital Beaujon, Clichy, France.
| | | | - Jean-Winoc Decousser
- Bacteriology Department, Hôpital Henri Mondor, APHP, Paris, France; Paris University, IAME, UMR 1137, INSERM, Paris F-75018, France.
| | - Bruno Fantin
- Internal Medicine, Hôpital Beaujon, Clichy, France; Paris University, IAME, UMR 1137, INSERM, Paris F-75018, France.
| | - Agnès Lefort
- Internal Medicine, Hôpital Beaujon, Clichy, France; Paris University, IAME, UMR 1137, INSERM, Paris F-75018, France.
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