Chia Nan University of Pharmacy & Science Institutional Repository:Item 310902800/31724
English  |  正體中文  |  简体中文  |  全文笔数/总笔数 : 17756/20057 (89%)
造访人次 : 7927949      在线人数 : 559
RC Version 7.0 © Powered By DSPACE, MIT. Enhanced by NTU Library IR team.
搜寻范围 查询小技巧:
  • 您可在西文检索词汇前后加上"双引号",以获取较精准的检索结果
  • 若欲以作者姓名搜寻,建议至进阶搜寻限定作者字段,可获得较完整数据
  • 进阶搜寻


    標題: Impacts of Hypervirulence Determinants on Clinical Features and Outcomes of Bacteremia Caused by Extended-Spectrum -Lactamase-Producing Klebsiella pneumoniae
    作者: Yu, Wen-Liang
    Lee, Mei-Feng
    Chen, Chi-Chung
    Tang, Hung-Jen
    Ho, Chung-Han
    Chuang, Yin-Ching
    貢獻者: Chi Mei Med Ctr, Dept Intens Care Med
    Taipei Med Univ, Dept Med
    Chi Mei Med Ctr, Dept Med Res
    Chi Mei Med Ctr, Dept Internal Med
    Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr
    Chi Mei Med Ctr Liou Ying, Dept Internal Med
    關鍵字: ESBL
    Klebsiella pneumoniae
    日期: 2017-04
    上傳時間: 2018-11-30 15:54:18 (UTC+8)
    出版者: Mary Ann Liebert, Inc
    摘要: We investigated the implications of hypervirulence determinants on clinical features of 48 adult patients with bacteremia caused by extended-spectrum -lactamase-producing Klebsiella pneumoniae. Isolates in the hypervirulence group included any of the following virulence determinants: K1/K2 capsule serotypes, hypermucoviscosity phenotype, rmpA gene, or rmpA2 gene. Nonhypervirulence group isolates were negative for all of the above virulence factors. In this study, all isolates used were non-K1/K2 strains. Statistically significant differences were observed in clinical features of patients between the two groups. The hypervirulent isolates (n=19), including 11 isolates with the hypermucoviscosity phenotype, 15 with the rmpA gene, and 16 with the rmpA2 gene, were more commonly recovered from diabetic patients and mainly manifested as secondary bacteremia (such as pneumonia, urinary tract infections, or other localized infections). The nonhypervirulent isolates (n=29) were more commonly recovered from patients after prolonged hospital stays (>30 days) and mostly manifested as primary bacteremia. The overall in-hospital mortality was 56.3%. Hazard ratio (HR) analysis revealed the following positive predictors for mortality: nosocomial infection, stay in an intensive care unit, no removal of the central venous catheter, Charlson comorbidity score, and APACHE II score (15). The negative predictors were initial appropriate antibiotic therapy (HR 0.42) and urinary tract infection (HR 0.19). Charlson score was an independent confounder based on multivariate analysis (HR 1.43, 95% confidence interval 1.04-1.99). In conclusion, hypervirulence determinants played a role in causing secondary infections in diabetic patients; however, the presence of morbidity cofactors could themselves influence mortality, despite the absence of hypervirulence determinants.
    關聯: Microbial Drug Resistance, v.23, n.3, pp.376-383
    显示于类别:[保健營養系(所) ] 期刊論文


    档案 描述 大小格式浏览次数

    在CNU IR中所有的数据项都受到原著作权保护.


    DSpace Software Copyright © 2002-2004  MIT &  Hewlett-Packard  /   Enhanced by   NTU Library IR team Copyright ©   - 回馈