HOSPITAL OUTCOMES OF ADULT RESPIRATORY TRACT INFECTIONS WITH EXTENDED-SPECTRUM B-LACTAMASE (ESBL) PRODUCING KLEBSIELLA PNEUMONIAE

Klebsiella pneumoniae ranks high as a cause of adult pneumonia requiringhospitalization in Malaysia. To study whether extended-spectrum b-lactamase(ESBL) producing K. pneumoniae was linked to hospital outcomes, weretrospectively studied 441 cases of adult respiratory tract infections with microbialproven K. pneumoniae from an urban-based university teaching hospital between2003 and 2004. 47 (10.6%) cases had ESBL. Requirement for ventilation andmedian length of hospital stay, were greater in ‘ESBL’ than in ‘non-ESBL’ group[34% vs. 7.4%, p 0.001; 14 days vs. 5 days, p 0.001 respectively] but not crudehospital mortality rate [21.3% vs. 12.4%, p=0.092]. There was a four-fold increasedrisk of requiring ventilation [4.61 (2.72-7.85)] when ESBL was present. Our findingssupport the association of ESBL producing K. pneumoniae with adversed hospitaloutcomes and reiterate the need for vigilance on the part of treating clinicians.