EPIDEMIOLOGY OF KLEBSIELLA BACTEREMIA - A CASE-CONTROL STUDY USING ESCHERICHIA-COLI BACTEREMIA AS CONTROL

Epidemiological data from 117 episodes of Klebsiella bacteraemia were compared with those from matched controls with Escherichia coli bacter aemia. Cases and controls were obtained from 20631 blood cultures take n from patients in Hvidovre Hospital between 1990 and 1992. The data s tudied included: sex and age, risk factors, portal of entry, outcome, nosocomial acquisition and distribution within the hospital. The incid ence of Klebsiella bacteraemia was 9.3/10000 admissions (76% Klebsiell a pneumoniae; 24% Klebsiella oxytoca). Patients with Klebsiella and E. coli bacteraemia had many common features, including a high incidence of neoplastic disease, biliary tract disease, and renal failure. Many had undergone surgery or received therapy with steroids, antacids or antibiotics. Klebsiella bacteraemia was more often found in males, in patients with hospital contact within the previous month, and polymicr obial infection. Logistic regression analysis showed that use of invas ive plastic devices and diabetes were significantly associated with Kl ebsiella bacteraemia. The urinary tract was the commonest source, foll owed by the biliary tract; 27% of patients had no obvious focus of inf ection, and in many of these an invasive device may have been involved . Forty-five K-serotypes were found-the largest number being nine stra ins of type K3; only a few strains had acquired resistance characters to antimicrobial agents. There were no differences between community a nd hospital-acquired strains; indicating that our hospital does not ha ve a resident strain of Klebsiella.