Laboratory blood parameters as predictors of duration of inpatient treatment for community-acquired pneumonia caused by Klebsiella pneumoniae
https://doi.org/10.36604/1998-5029-2026-99-102-110
Abstract
Aim. To determine the diagnostic significance of laboratory blood parameters in predicting the duration of inpatient treatment for community-acquired pneumonia (CAP) caused by Klebsiella pneumoniae.
Materials and methods. Study design: single-center, continuous, retrospective case series study; study subjects: 52 patients (all HIV-negative), 55.8 % (29/52) male and 44.2 % (23/52) female, diagnosed with CAP caused by K. pneumoniae; study duration: from 2016 to 2022; primary endpoint: recovery and discharge of the patient from hospital; Description of methods: analysis of paired contingency tables – Pearson's criteria (χ2), (without Yates's correction for continuity) for df = 1, logistic regression (simple and multiple).
Results. Statistically significant threshold values predictive of hospitalization exceeding 10 days were identified as follows: lymphocyte count ≤ 2.01 × 109/L, monocyte count ≤ 0.68 × 109/L (lower values associated with increased risk), and erythrocyte sedimentation rate (ESR) ≥ 52 mm/h (higher values associated with increased risk).
Conclusion. The prognosis for the duration of hospitalization longer than 10 days during treatment for CAP caused by K. pneumoniae can be determined with a high degree of probability using three laboratory parameters of a complete blood count or a combination of them (lymphocyte, monocyte, and ESR levels).
Keywords
Klebsiella pneumoniae,
lymphocytes,
monocytes,
erythrocyte sedimentation rate (ESR),
prognosis,
logistic regression
Supporting agencies: This study was not sponsored
About the Author
V. S. Borovitsky
Federal State Institution "Research Institute of the Federal Penitentiary Service"; Kirov Regional State Budgetary Healthcare Institution "Kirovo-Chepetsk Central District Hospital"
Russian Federation
Russian Federation
Vladislav S. Borovitsky, MD, PhD, DSc (Med.), Main Staff Scientist, Pulmonologist
125130; building 1, 15a Narvskaya Str.; Moscow; 613040; 3 Sozontova Str.; Kirov Region; Kirovo-Chepetsk
References
1. Podschun R., Ullmann U. Klebsiella spp. as nosocomial pathogens: epidemiology, taxonomy, typing methods, and pathogenicity factors. Clin. Microbiol. Rev. 1998; 11(4):589–603. doi: 10.1128/CMR.11.4.589
2. Podschun R., Pietsch S., Höller C., Ullmann U. Incidence of Klebsiella species in surface waters and their expression of virulence factors. Appl. Environ Microbiol. 2001; 67(7):3325–3327. doi: 10.1128/AEM.67.7.3325-3327.2001
3. De Oliveira D.M.P., Forde B.M., Kidd T.J., Harris P.N.A., Schembri M.A., Beatson S.A., Paterson D.L., Walker M.J. Antimicrobial resistance in ESKAPE pathogens. Clin. Microbiol. Rev. 2020; 33(3):e00181-199. doi: 10.1128/CMR.00181-19
4. Choby J.E., Howard-Anderson J., Weiss D.S. Hypervirulent Klebsiella pneumoniae – clinical and molecular perspectives. J. Intern. Med. 2020; 287(3):283–300. doi: 10.1111/joim.13007
5. Li W., Sun G., Yu Y., Li N., Chen M., Jin R., Jiao Y., Wu H. Increasing occurrence of antimicrobial-resistant hypervirulent (hypermucoviscous) Klebsiella pneumoniae isolates in China. Clin. Infect. Dis. 2014; 58(2):225–232. doi: 10.1093/cid/cit675
6. Liu C., Shi J., Guo J. High prevalence of hypervirulent Klebsiella pneumoniae infection in the genetic background of elderly patients in two teaching hospitals in China. Infect. Drug Resist. 2018; 11:1031–1041. doi: 10.2147/IDR.S161075
7. Effah C.Y., Sun T., Liu S., Wu Y. Klebsiella pneumoniae: an increasing threat to public health. Ann. Clin. Microbiol. Antimicrob. 2020; 19(1):1. doi: 10.1186/s12941-019-0343-8
8. Gu D., Dong N., Zheng Z., Lin D., Huang M., Wang L., Chan E.W., Shu L., Yu J., Zhang R., Chen S. A fatal outbreak of ST11 carbapenem-resistant hypervirulent Klebsiella pneumoniae in a Chinese hospital: a molecular epidemiological study. Lancet Infect. Dis. 2018; 18(1):37–46. doi: 10.1016/S1473-3099(17)30489-9
9. Wang Y., Zhang Q., Jin Y., Jin X., Yu J., Wang K. Epidemiology and antimicrobial susceptibility profiles of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae and Escherichia coli in China. Braz. J. Microbiol. 2019; 50(3):669–675. doi: 10.1007/s42770-019-00081-7
10. Yang Q., Jia X., Zhou M., Zhang H., Yang W., Kudinha T., Xu Y. Emergence of ST11-K47 and ST11-K64 hypervirulent carbapenem-resistant Klebsiella pneumoniae in bacterial liver abscesses from China: a molecular, biological, and epidemiological study. Emerg. Microbes. Infect. 2020; 9(1):320–331. doi: 10.1080/22221751.2020.1721334
11. Hu D., Li Y., Ren P., Tian D., Chen W., Fu P., Wang W., Li X., Jiang X. Molecular epidemiology of hypervirulent carbapenemase-producing Klebsiella pneumoniae. Front. Cell Infect. Microbiol. 2021; 11:661218. doi: 10.3389/fcimb.2021.661218
12. Tian D., Liu X., Chen W., Zhou Y., Hu D., Wang W., Wu J., Mu Q., Jiang X. Prevalence of hypervirulent and carbapenem-resistant Klebsiella pneumoniae under divergent evolutionary patterns. Emerg. Microbes Infect. 2022; 11(1):1936–1949. doi: 10.1080/22221751.2022.2103454
13. Avdeev S.N., Dehnich A.V., Zajcev A.A., Kozlov R.S., Rachina S.A., Rudnov V.A., Sinopal'nikov A.I., Tjurin I.E., Fesenko O.V., Chuchalin A.G. [Community-acquired pneumonia : federal clinical guidelines for diagnosis and treatment]. Pul'monologija = Pulmonology. 2022; 32(3):295–355 (in Russian). doi: 10.18093/0869-0189-2022-32-3-295-355
14. Lang T.A., Sesik M. [How to Report Statistics in Medicine. Annotated Guidelines for Authors, Editors, and Reviewers]. Moscow: Practical Medicine, 2011 (in Russian). ISBN: 978-5-98811-173-4.
15. Petri A., Sebin K. [Comprehensive medical statistics]. Moscow: GEOTAR-Media, 2009 (in Russian). ISBN: 978-5-9704-0914-5.
16. DeLong E.R., DeLong D.M., Clarke-Pearson D.L. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 1988; 44:837–845.
17. Self W.H., Balk R.A., Grijalva C.G., Williams D.J., Zhu Y., Anderson E.J., Waterer G.W., Courtney D.M., Bramley AM., Trabue C., Fakhran S., Blaschke A.J., Jain S., Edwards K.M., Wunderink R.G. Procalcitonin as a marker of etiology in adults hospitalized with community-acquired pneumonia. Clin. Infect. Dis. 2017; 65:183–190. doi: 10.1093/cid/cix317
18. Ansar W., Ghosh S. C-reactive protein and the biology of disease. Immunol. Res. 2013; 56:131–142. doi: 10.1007/s12026-013-8384-0
19. Branche A., Neeser O., Mueller B., Schuetz P. Procalcitonin to guide antibiotic decision making. Curr. Opin. Infect. Dis. 2019; 32:130–135. doi: 10.1097/QCO.0000000000000522
20. Krüger S., Ewig S., Giersdorf S., Hartmann O., Suttorp N., Welte T. Cardiovascular and inflammatory biomarkers to predict short- and long-term survival in community-acquired pneumonia. Am. J. Respir. Crit. Care Med. 2010; 182:1426–1434. doi: 10.1164/rccm.201003-0415OC
21. Bello S., Lasierra A.B., Mincholé E., Fandos S., Ruiz M.A., Vera E., de Pablo F., Ferrer M., Menendez R., Torres A. Prognostic power of proadrenomedullin in community-acquired pneumonia is independent of aetiology. Eur. Respir. J. 2012; 39:1144–1155. doi: 10.1183/09031936.00080411
22. Klouche K., Cristol J.P., Devin J., Gilles V., Kuster N., Larcher R., Amigues L., Corne P., Jonquet O., Dupuy A.M. Diagnostic and prognostic value of soluble CD14 subtype (Presepsin) for sepsis and community-acquired pneumonia in ICU patients. Ann. Intensive Care 2016; 6:59. doi: 10.1186/s13613-016-0160-6
23. Chalkias A., Skoulakis A., Papagiannakis N., Laou E., Tourlakopoulos K., Pagonis A., Michou A., Ntalarizou N., Mermiri M., Ragias D., Bernal-Morell E., Cebreiros López I., García de Guadiana-Romualdo L., Eugen-Olsen J., Gourgoulianis K., Pantazopoulos I. Circulating suPAR associates with severity and in-hospital progression of COVID-19. Eur. J. Clin. Investig. 2022; 52:e13794. doi: 10.1111/eci.13794
24. Ganaie Z.A., Aqel Y., Almaalouli B., Alsarkhi L.N., Dar A.K, Abusal A.M., Wei C.R., Amin A. Association between elevated neutrophil-to-lymphocyte ratio and mortality risk in community-acquired pneumonia : a systematic review and meta-analysis. Cureus 2025; 17(9):e93292. doi: 10.7759/cureus.93292
Review
For citations:
Borovitsky V.S. Laboratory blood parameters as predictors of duration of inpatient treatment for community-acquired pneumonia caused by Klebsiella pneumoniae. Bulletin Physiology and Pathology of Respiration. 2026;(99):102-110. (In Russ.) https://doi.org/10.36604/1998-5029-2026-99-102-110
Views:
116
JATS XML
Email this article 