{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T07:17:29Z","timestamp":1791098249934,"version":"4.1.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2012,1,10]],"date-time":"2012-01-10T00:00:00Z","timestamp":1326153600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In many Asian countries,<jats:italic>Klebsiella pneumoniae<\/jats:italic>(KP) is the second pathogen responsible for community-acquired pneumonia. Yet, very little is known about<jats:italic>KP<\/jats:italic>etiology in ALRI in Cambodia, a country that has one of the weakest medical infrastructures in the region. We present here the first clinico-radiological description of<jats:italic>KP<\/jats:italic>community-acquired ALRI in hospitalized Cambodian patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Through ALRI surveillance in two provincial hospitals,<jats:italic>KP<\/jats:italic>was isolated from sputum and blood cultures, and identified by API20E gallery from patients \u2265 5 years-old with fever and respiratory symptoms onset \u226414 days. Antibiotics susceptibility testing was provided systematically to clinicians when bacteria were isolated. We collected patients' clinical, radiological and microbiological data and their outcome 3 months after discharge. We also compared<jats:italic>KP<\/jats:italic>-related with other bacteria-related ALRI to determine risk factors for<jats:italic>KP<\/jats:italic>infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From April 2007 to December 2009, 2315 ALRI patients \u2265 5 years-old were enrolled including 587 whose bacterial etiology could be assigned. Of these, 47 (8.0%) had<jats:italic>KP<\/jats:italic>infection; their median age was 55 years and 68.1% were females. Reported prior medication was high (42.5%). Patients' chest radiographs showed pneumonia (61.3% including 39% that were necrotizing), preexisting parenchyma lesions (29.5%) and pleural effusions alone (4.5%) and normal parenchyma (4.5%). Five patients had severe conditions on admission and one patient died during hospitalization. Of the 39 patients that were hospital discharged, 14 died including 12 within 1 month after discharge. Only 13 patients (28%) received an appropriate antibiotherapy. Extended-spectrum beta-lactamases (ESBL) - producing strains were found in 8 (17.0%) patients. Female gender (Odds ratio (OR) 2.1;<jats:italic>p<\/jats:italic>= 0.04) and diabetes mellitus (OR 3.1;<jats:italic>p<\/jats:italic>= 0.03) were independent risk factors for<jats:italic>KP<\/jats:italic>-related ALRI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:italic>KP<\/jats:italic>ALRI in Cambodia has high fatality rate, are more frequently found in women, and should be considered in diabetic patients. The extremely high frequency of ESBL-producing strains in the study is alarming in the context of uncontrolled antibiotic consumption and in absence of microbiology capacity in most public-sector hospitals.<\/jats:p><\/jats:sec>","DOI":"10.1186\/1471-2334-12-3","type":"journal-article","created":{"date-parts":[[2012,1,10]],"date-time":"2012-01-10T19:30:55Z","timestamp":1326223855000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Klebsiella pneumoniaerelated community-acquired acute lower respiratory infections in Cambodia: Clinical characteristics and treatment"],"prefix":"10.1186","volume":"12","author":[{"given":"Blandine","family":"Rammaert","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Goyet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Beaut\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sopheak","family":"Hem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vantha","family":"Te","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrich Lorn","family":"Try","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Mayaud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Borand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Buchy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertrand","family":"Guillard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sirenda","family":"Vong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2012,1,10]]},"reference":[{"issue":"5","key":"1698_CR1","doi-asserted-by":"publisher","first-page":"816","DOI":"10.3346\/jkms.2006.21.5.816","volume":"21","author":"CI Kang","year":"2006","unstructured":"Kang CI, Kim SH, Bang JW, Kim HB, Kim NJ, Kim EC, Oh MD, Choe KW: Community-acquired versus nosocomial Klebsiella pneumoniae bacteremia: clinical features, treatment outcomes, and clinical implication of antimicrobial resistance. 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