Hostname: page-component-8448b6f56d-qsmjn Total loading time: 0 Render date: 2024-04-24T22:41:20.177Z Has data issue: false hasContentIssue false
  • English
  • Français

Klebsiella oxytoca Isolates in a General Hospital

Published online by Cambridge University Press:  02 January 2015

Salvador Alvarez ,
Joy A. Stinnett ,
Charles G. Shell  and
Steven L. Berk
Salvador Alvarez*
Affiliation:
Infectious Disease Section, Department of Medicine, Veterans Administration Medical Center, Quillen-Dishner College of Medicine, East Tennessee State University, Johnson City, Tennessee
Joy A. Stinnett
Affiliation:
Infectious Disease Section, Department of Medicine, Veterans Administration Medical Center, Quillen-Dishner College of Medicine, East Tennessee State University, Johnson City, Tennessee
Charles G. Shell
Affiliation:
Infectious Disease Section, Department of Medicine, Veterans Administration Medical Center, Quillen-Dishner College of Medicine, East Tennessee State University, Johnson City, Tennessee
Steven L. Berk
Affiliation:
Infectious Disease Section, Department of Medicine, Veterans Administration Medical Center, Quillen-Dishner College of Medicine, East Tennessee State University, Johnson City, Tennessee
*
Infectious Disease Section, Veterans Administration Medical Center, Johnson City, TN 37684
Get access Rights & Permissions [Opens in a new window]

Abstract

Primary infections caused by Klebsiella species are uncommon, but the organism is an important nosocomial pathogen. We report the predisposing factors, clinical features and outcome of 44 hospitalized patients in whom Klebsiella oxytoca was isolated. Twenty-one (48%) isolates were community-acquired and 23 (52%) were considered nosocomial in origin. Most of the patients were elderly males with serious underlying diseases. There were significant differences between those patients who acquired Klebsiella oxytoca in the hospital and in the community. Nosocomially acquired organisms were associated with a higher mortality (52% vs. 24%) (p<0.05), a higher incidence of infection vs. colonization (83% vs. 57%) (p<0.05), and a higher percentage of cases of pneumonia (43% vs. 19%) (p<0.05). The clinical features, the hospital service and the patients' underlying diseases were similar when patients who died and those who survived were compared. Patients who died were exposed to antibiotics more often prior to the positive culture with K. oxytoca (p<0.05). K. oxytoca is a significant pathogen in hospitalized elderly patients. It is likely to cause infections, especially pneumonia, and carry a high mortality. The organism can become endemic within the hospital setting with continued carriage and nosocomial spread.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 6 , Issue 8 , August 1985 , pp. 310 - 313
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1985

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Edmonson, EB, Sanford, JP: The Klebsiella-Enterobacter (aerobacter)—Serratia. Medicine 1967; 46:323–340.Google Scholar
2.Flugge, C: Die Mikroorganismen. Leipzig, 1886.Google Scholar
3.Cowan, ST, Steel, KJ: Manual for the Identification of Medical Bacteria, ed 2. 1974. Cambridge, Cambridge University Press, p 111.Google Scholar
4.Brenner, DJ, Farmer, JS IIIHickman, FW, et al: Taxonomic and nomenclature changes in Enterobacteriacea. HEW Publication No. (CDC) 79-8356. Centers for Disease Control, Atlanta, 1977.Google Scholar
5.Ristuccia, PA, Cunha, BA: Topics in clinical microbiology—Klebsiella. Infect Control 1984; 5:343–347.Google Scholar
6.Power, JT, Calder, MA: Pathogenic significance of Klebsiella oxytoca in acute respiratory infections. Thorax 1983: 38:205–208.Google Scholar
7.Cabbabe, EB, Herbold, DR, Sunwoo, YC, et al: Postradiation flap infection about the oral cavity. Ann Plast Surg 1983; 10:488–491.Google Scholar
8.Ruden, H, Gondermann, KO: Case report of the contamination of preserved blood with Klebsiella oxytoca and Serratia liquefaciens. Zentralbl Bakteriol Mikrobiol Hyg(B) 1982; 176:444–452.Google Scholar
9.Orskov, I: Genus v., Klebsiella, in Krieg, NR, Holt, JG (eds): Bergey's Manual of Systematic Bacteriology. Baltimore/London, Williams and Wilkins, 1984, p 464.Google Scholar
10.Bauer, AW, Kirby, WMM, Sherris, JC, et al: Antibiotic susceptibility testing by a standardized single disc method. Am J Clin Pathol 1966; 45:493–496.Google Scholar
11.Outline for surveillance and control of nosocomial infections. Atlanta, GA, Centers for Disease Control, November 1976.Google Scholar
12.Allegra, D, Parrott, P, Terry, P, et al: Nosocomial spread of Klebsiella oxytoca after the use of a contaminated commercial soap product, abstract 8th Educational Conference, APIC, Atlanta, GA, 1981.Google Scholar
13.Sullivan, RJ, Dowdle, WR, Marine, WM, et al: Adult pneumonia in a general hospital. Arch Intern Med 1972; 129:935–942.Google Scholar
14.Verghese, A, Berk, SL: Bacterial pneumonia in the elderly. Medicine 1983; 62:271–285.Google Scholar
15.Natural Nosocomial Infection Study Report. Centers for Disease Control Annual Summary of 1975, 1977.Google Scholar
16.Mertz, JJ, Scharer, L, McClement, JH: A hospital outbreak of Klebsiella pneumoniae from inhalation therapy with contaminated aerosol solution. Am Rev Respir Dis 1967; 95:454–459.Google Scholar