{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T05:51:46Z","timestamp":1781070706019,"version":"3.54.1"},"reference-count":36,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T00:00:00Z","timestamp":1649808000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T00:00:00Z","timestamp":1649808000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T00:00:00Z","timestamp":1649808000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Acute cholangitis (AC) is a potentially life\u2010threatening infection involving the biliary system. The two commonest bacteria involved are <jats:italic>Escherichia coli<\/jats:italic> (<jats:italic>EC<\/jats:italic>) followed by <jats:italic>Klebsiella pneumoniae<\/jats:italic> (<jats:italic>KP<\/jats:italic>). Microbiology is a prognostic factor for several pathologies but not for AC. We aim to investigate clinical outcomes between <jats:italic>KP<\/jats:italic> bacteremia vs. <jats:italic>EC<\/jats:italic> bacteremia in AC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective cohort study of patients diagnosed with calculous AC (January\u2013December 2016). Study outcomes include the length of hospitalization stay, in\u2010hospital mortality, 30\u2010day, and 90\u2010day mortality. Univariate and multivariate logistic regression was used to establish correlations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 141 patients (<jats:italic>KP<\/jats:italic> (<jats:italic>n<\/jats:italic>\u2009=\u200929), <jats:italic>EC<\/jats:italic> (<jats:italic>n<\/jats:italic>\u2009=\u2009112)) with overall median age of 82.2 and similar gender distribution. Most patients had Grade II AC (<jats:italic>n<\/jats:italic>\u2009=\u200959, 41.8%). Patient demographics were comparable. <jats:italic>KP<\/jats:italic> bacteremia had lower median platelet count (<jats:italic>KP<\/jats:italic>:168\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L vs. <jats:italic>EC<\/jats:italic>:200\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L; <jats:italic>p<\/jats:italic>\u2009=\u20090.025). Overall 30\u2010day and 90\u2010day mortality were 9.2 and 10.6%, respectively. Multivariate analysis showed <jats:italic>KP<\/jats:italic> bacteremia had higher 30\u2010day (Odds ratio (OR) 6.09, (95% Confidence Interval (CI):1.27\u201329.10), <jats:italic>p<\/jats:italic>\u2009=\u20090.024) and 90\u2010day mortality (OR 6.10, 95% CI: 1.39\u201326.76, <jats:italic>p<\/jats:italic>\u2009=\u20090.017). The length of hospitalization stay was comparable. Subgroup analysis of endoscopic retrograde cholangiopancreatogram patients showed comparable outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:italic>KP<\/jats:italic> bacteremia is associated with lower platelet count and higher 30\u2010day and 90\u2010day mortality than <jats:italic>EC<\/jats:italic>. More studies are required to establish if inferior outcomes of <jats:italic>KP<\/jats:italic> bacteremia are associated with antimicrobial resistance.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-022-06559-0","type":"journal-article","created":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T18:03:03Z","timestamp":1649872983000},"page":"1678-1685","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["<i>Klebsiella pneumoniae<\/i> Bacteremia is Associated with Higher Mortality in Acute Calculous Cholangitis as Compared to <i>Escherichia coli<\/i> Bacteremia"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9533-801X","authenticated-orcid":false,"given":"Kai Siang","family":"Chan","sequence":"first","affiliation":[{"name":"Department of General Surgery Tan Tock Seng Hospital 11 Jalan Tan Tock Seng 308433 Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishal G.","family":"Shelat","sequence":"additional","affiliation":[{"name":"Department of General Surgery Tan Tock Seng Hospital 11 Jalan Tan Tock Seng 308433 Singapore 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Collected data were de-identified and only accessible to members of the study team with no subsequent patient contact for data collection purposes. The study team made no attempts to access patients' medical records via the national electronic health record system.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent statement"}}]}}