Hypervirulent Klebsiella pneumoniae-related bacteremia in intensive care unit: A retrospective cohort study

Marin Moutel; Edwidge Peju; Martin Belan; Ariane Gavaud; Jean-Paul Mira; Caroline Charlier; Etienne Canouï; Nabil Gastli

doi:10.1016/j.idnow.2024.104892

Hypervirulent Klebsiella pneumoniae-related bacteremia in intensive care unit: A retrospective cohort study

Infect Dis Now. 2024 Mar 22;54(5):104892. doi: 10.1016/j.idnow.2024.104892. Online ahead of print.

Authors

Marin Moutel¹, Edwidge Peju², Martin Belan³, Ariane Gavaud⁴, Jean-Paul Mira², Caroline Charlier⁵, Etienne Canouï⁶, Nabil Gastli⁷

Affiliations

¹ Équipe mobile d'infectiologie, Hôpitaux Universitaires Paris Centre-Cochin Port Royal, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
² Service de médecine intensive-réanimation, Hôpitaux Universitaires Paris Centre-Cochin Port Royal, APHP, 27 rue du faubourg Saint Jacques, Paris, France; Université Paris Cité, Paris, France; Institut Cochin, INSERM U1016, CNRS UMR 8104, Université Paris Cité, 22 rue Méchain, 75014 Paris, France.
³ Équipe mobile d'infectiologie, Hôpitaux Universitaires Paris Centre-Cochin Port Royal, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; Université Paris Cité, Paris, France.
⁴ Service de médecine intensive-réanimation, Hôpitaux Universitaires Paris Centre-Cochin Port Royal, APHP, 27 rue du faubourg Saint Jacques, Paris, France.
⁵ Équipe mobile d'infectiologie, Hôpitaux Universitaires Paris Centre-Cochin Port Royal, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; Université Paris Cité, Paris, France; Centre National de Référence Listeria, Unité de Biologie des Infections, Inserm U1117, Institut Pasteur 75015, Paris, France.
⁶ Équipe mobile d'infectiologie, Hôpitaux Universitaires Paris Centre-Cochin Port Royal, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France. Electronic address: etienne.canoui@aphp.fr.
⁷ Service de bactériologie, AP-HP, Hôpitaux Universitaires Paris Centre-Cochin Port Royal, Paris, France.

PMID: 38521127
DOI: 10.1016/j.idnow.2024.104892

Abstract

Introduction: Hypervirulent Klebsiella pneumoniae (hvKP) bloodstream infections (BSI) have rarely been reported in critically ill patients.

Methods: We conducted a retrospective study of KP-BSI between January 2016 and December 2020 in an adult medical intensive care unit (ICU) of our tertiary care hospital. Hypervirulent phenotype was defined by the detection of both rmpA and iutA.

Results: Seventy patients diagnosed with K. pneumonia BSI were included, of whom 9 (13 %) had hvKP infection. Pneumonia accounted for 56 % of hvKP-BSI and for 28 % of those with cKP. Fifty-six percent of patients with hvKP-BSI were homeless, versus 2 % of those with cKP-BSI (p < 0.001). The 30-day mortality rate reached 44 % for hvKP-BSI and 34 % for cKP-BSI (p = 0.7) and did not appear related to the hypervirulent phenotype in multivariable analysis.

Discussion: We here evidenced a new clinical entity of hvKP-BSI associated with pulmonary infection in homeless patients, which exhibits high mortality.