Table 1.
Clinical reports of Klebsiella pneumoniae infections in Singapore.
| Year of Publication | Patient description | Kp cases | Kp-associated mortality (%) | Other Notes | Ref. |
|---|---|---|---|---|---|
| BACTERAEMIA | |||||
| 1994 | Patients with Kp bacteraemia | 101 | 26 | Source of bacteraemia unknown (33%), Liver abscess (17%), UTI (29%) Pneumonia (9%), HBS (3%), Abscess other than liver (10%) |
Lee et al., 1994 |
| 2008 | Patients with Kp bacteraemia | 133 | 20.3 | HBS 38.3% including liver abscess in 18.0%, Pneumonia (13.3%), UTI (28.1%), Unknown source (14.8%), Others (5.5%) 5/133 (3.8%) developed endopthalmitis, all of whom had liver abscesses |
Sng et al., 2008 |
| 2015 | Patients with Kp bacteraemia | 134 | 23.1 | HBS 36.3%, including liver abscess in 14.2%, Respiratory 20.1%, No differences in mortality for cefazolin compared to 3rd generation cephalosporin |
Ng et al., 2015 |
| 2017 | Patients with Kp bacteraemia | 129 | 25.6 | HBS 34.1% including liver abscess in 16.3%, Pneumonia 18.6%, Pyelonephritis 11.6%, Cystitis 16.3%, Other intraabdominal source 8.5%, Meningitis 0.8%, Others 3.9%, Unknown 6.2% | Tan et al., 2017 |
| PNEUMONIA | |||||
| 1996 | Patients with CAP admitted to ICU | 9/61 (15%) | N/A | Kp was the most commonly identified pathogen | Lee et al., 1996 |
| 1998 | Patients with CAP admitted to ICU | 5/57 (9%) | 3/5 (60%) | Kp was the third most commonly isolated pathogen (Tied with Staphylococcus aureus) | Tan et al., 1998 |
| 1999 | Patients with HAP admitted to ICU | 6/24 (25%)* | N/A | Kp was the most commonly identified pathogen | Stebbings et al., 1999 |
| URINARY TRACT INFECTIONS | |||||
| 2010 | ICU patients with UTI acquired during ICU admission | 3/35 (8.6%) | N/A | Kp was the second most commonly isolated pathogen (Tied with Escherichia coli) | Tay et al., 2010 |
| 2011 | Community clinic patients with UTI | 29/333 (8.7%) | N/A | Kp was the second most commonly isolated pathogen | Bahadin et al., 2011 |
| LIVER ABSCESS | |||||
| 2005 | Review of patients with liver abscess, comparing PD vs SD | 51/80 (63.8%) PD: 24/36 (66.7%) SD: 27/44 (61.4%) |
Overall: 3/80 (3.8%), PD: 1/36 (2.8%), SD: 2/44 (4.5%) Kp specific rates N/A |
Kp was the most commonly identified pathogen Similar treatment outcomes, except for fewer treatment failures in SD (3/44) compared to PD (10/36) |
Tan et al., 2005 |
| 2013 | Review of patients with Kp liver abscess undergoing treatment in OPAT | 109/205 (53%) | 0% |
Kp was the most commonly identified pathogen Delayed response in 29/109 (27%) patients, associated with abscess >5 cm Three require readmission |
Chan et al., 2013 |
| 2015 | Adults with pyogenic liver abscess | 292/741 (39%) of positive fluid cultures 220/741 (30%) of positive blood cultures |
N/A | Kp was the most commonly identified pathogen | Zhi et al., 2015 |
| MENINGITIS | |||||
| 2002 | Reviewed cases of meningitis/ meningoencephalitis |
2/269 (0.7%) of clinical cases 2/15 (13.3%) culture positive cases |
N/A | Only 15 cases were culture positive. The breakdown of positive cultures are as follows: 4 Streptococcus pneumoniae, 3 each of Streptococcus agalactiae and Neisseria meningitidis, 2 each of Kp and Listeria monocytogenes, and 1 Streptococcus suis | Chan et al., 2002 |
| ENDOGENOUS ENDOPHTHALMITIS | |||||
| 2000 | Reviewed cases of endogenous bacterial endopthalmitis | 16/27 (59.3%) | N/A | 11 of 16 (68.8%) Kp cases were associated with liver abscess | Wong et al., 2000 |
| 2011 | Consecutive Kp endogenous endopthalmitis cases reviewed | 61 patients (71 eyes) | N/A | 47/61 (77.5%) were associated with liver abscess 54/71 (80.2%) eyes had poor vision (VA worse than 4/200) 19/71 (26.8%) required evisceration |
Ang et al., 2011 |
CAP, Community-acquired pneumonia; ICU, Intensive care unit; HAP, Hospital-acquired pneumonia; UTI, Urinary tract infection; HBS, Hepatobiliary sepsis; OPAT, Outpatient parenteral antibiotic therapy; PD, Percutaneous drainage; SD, Surgical drainage; VA, Visual acuity.
*
One patient with Kp had multiple organisms cultured.