https://scholars.lib.ntu.edu.tw/handle/123456789/561046
標題: | The prevalence of rectal carriage of Klebsiella pneumoniae amongst diabetic patients and their clinical relevance in Taiwan: A five-year prospective study | 作者: | YU-TSUNG HUANG Jiang J.-Y. Hsu M.-S. Hsu H.-S. Liao C.-H. PO-REN HSUEH |
公開日期: | 2018 | 卷: | 51 | 期: | 4 | 起(迄)頁: | 510-518 | 來源出版物: | Journal of Microbiology, Immunology and Infection | 摘要: | Background/purpose: Pyogenic liver abscess (PLA) and bacteremia caused by Klebsiella pneumoniae is a common complication among patients with diabetes mellitus (DM). The aim of this study is to investigate the prevalence of rectal carriage and serotype distribution of K. pneumoniae amongst DM patients and their clinical relevance. Methods: We prospectively collected rectal swabs for K. pneumoniae culture in asymptomatic DM patients from March 2008 to June 2009. Seven capsular serotypes that were commonly associated with PLA were determined by capsular polysaccharide synthesis (cps) genotyping. Microbiologically confirmed bacterial infections were evaluated 1 and 5 years after initial enrolment of the patients. Results: A total of 100 male and 62 female patients (mean age, 56.6 years) were enrolled. Of these, 77 (47.5%) had rectal K. pneumoniae colonization. Colonizers were older than non-colonizers (p = 0.03). Sex, fasting blood glucose, and initial HbA1C were not statistically different (p = 0.26, 0.18, and 0.31, respectively). Among the 65 available isolates, 22 (33.8%) belonged to the seven main serotypes. During the 5-year's follow-up, 21 patients developed microbiologically documented bacterial infections but none of them developed PLA and bacteremia. Risk factors for bacterial infection within 5 years included initial glycosylated hemoglobin (HbA1C) > 10% or first-year average HbA1C > 10%. Conclusion: Although nearly half of asymptomatic DM patients had rectal carriage of K. pneumoniae and one-third of them colonized by isolates belonging to the seven serotypes related to PLA, none of them subsequently developed PLA and colonized patients did not have higher risk of microbiologically confirmed bacterial infections. ? 2017 |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/561046 | ISSN: | 1684-1182 | DOI: | 10.1016/j.jmii.2017.05.009 | SDG/關鍵字: | hemoglobin A1c; adult; Article; asymptomatic infection; bacterial capsule; bacterial colonization; bacterial peritonitis; bacterial pneumonia; bacterial sinusitis; bacterium culture; bloodstream infection; Citrobacter koseri; diabetes mellitus; diabetic patient; Enterococcus; Escherichia coli; female; Fusobacterium; hemoglobin blood level; human; Klebsiella pneumoniae; major clinical study; male; methicillin resistant Staphylococcus aureus; middle aged; nonhuman; prevalence; prospective study; pyogenic liver abscess; rectum; risk factor; Salmonella; serotype; Staphylococcus; Taiwan; urinary tract infection; wound infection; aged; classification; diabetic complication; genetics; genotype; heterozygote; isolation and purification; Klebsiella infection; Klebsiella pneumoniae; microbiology; prevalence; rectum; very elderly; young adult; Adult; Aged; Aged, 80 and over; Carrier State; Diabetes Complications; Female; Genotype; Humans; Klebsiella Infections; Klebsiella pneumoniae; Male; Middle Aged; Prevalence; Prospective Studies; Rectum; Risk Factors; Serogroup; Taiwan; Young Adult |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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