Time to positivity of Klebsiella pneumoniae in blood cultures as prognostic marker in patients with intra-abdominal infection: A retrospective study

ABSTRACT

Klebsiella pneumoniae is a common causative pathogen of intra-abdominal infection with concomitant bacteraemia, leading to a significant mortality risk. The time to positivity (TTP) of blood culture is postulated to be a prognostic factor in bacteraemia caused by other species. Therefore, this study aimed to investigate the prognostic value of TTP in these patients. The single-centred, retrospective, observational cohort study was conducted between 1 July 2016 and 30 June 2021. All adult emergency department patients with diagnosis of intra-abdominal infection and underwent blood culture collection which yield K. pneumoniae during this period were enrolled. A total of 196 patients were included in the study. The overall 30-day mortality rate was 12.2% (24/196), and the median TTP of the studied cohort was 12.3 h (10.5–15.8 h). TTP revealed a moderate 30-day mortality discriminative ability (area under the curve 0.73, p < 0.001). Compared with the late TTP group (>12 h, N = 109), patients in the early TTP (≤12 h, N = 87) group had a significantly higher risk of 30-day morality (21.8% vs. 4.6%, p < 0.01) and other adverse outcomes. Furthermore, TTP (odds ratio [OR] = 0.79, p = 0.02), Pitt bacteraemia score (OR = 1.30, p = 0.03), and implementation of source control (OR = 0.06, p < 0.01) were identified as independent factors related to 30-day mortality risk in patients with intra-abdominal infection and K. pneumoniae bacteraemia. Therefore, physicians can use TTP for prognosis stratification in these patients.

KEYWORDS:

• Prognosis
• blood culture
• time to positivity
• bacteraemia
• intra-abdominal infections
• Klebsiella pneumoniae

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

Yong-Ye Yang: Conceptualization, Writing – original draft

I-Ting Tsai: Methodology, Writing – original draft

Chung-Hsu Lai: Visualization, Formal analysis

Chih-Ping Chen: Data curation, Visualization

Chia‐Chi Chen: Data curation, Software

Yin-Chou Hsu: Conceptualization, Supervision, Writing – review & editing

Data availability statement

The datasets used and/or analysed during the present study are available from the corresponding author upon reasonable request.

Additional information

Funding

This research received no external funding.