Features of the clinical course of severe community-acquired pneumonia caused by Klebsiella pneumoniae in patients with acute leukemia
https://doi.org/10.52888/0514-2515-2022-355-4-76-82
Abstract
Aim: To compare the course of severe community-acquired pneumonia caused by Kl. pneumonia in patients with acute lymphoblastic and myeloblastic leukaemia.
Materials and methods. The study was designed as a retrospective, single-centre, controlled and non-randomized study and included 40 patients. They were divided into two groups: patients with acute myeloblastic leukaemia (22), mortality of 59% (13 patients) and patients with acute lymphoblastic leukaemia (18), mortality of 38% (7 patients).
Results and discussion. The combination of acute myeloblastic leukaemia and severe community-acquired pneumonia caused by Kl. pneumonia showed a higher mortality rate, a longer duration of respiratory support, as well as a greater frequency of involvement of organs and systems in the infectious process than in acute lymphoblastic leukaemia.
Conclusions: The development of pneumonia caused by Kl. pneumonia in patients with acute myeloblastic leukaemia is characterized by a more severe course. SOFA, APACHE-II, and PSI/PORT scales have limited predictive ability in patients with acute leukaemia and severe community-acquired pneumonia caused by Kl. Pneumoniae.
About the Authors
V. I. Saharov
Bashkir State Medical University
Russian Federation
Russian Federation
P. I. Mironov
Bashkir State Medical University
Russian Federation
Russian Federation
I. I. Lutfarakhmanov
Bashkir State Medical University
Russian Federation
Russian Federation
T. Sh. Ikromov
Postgraduate Health Education Institute of Tajikistan
Tajikistan
Tajikistan
References
1. Beloborodov V. B., Gusarov V.G., Dekhnich A.V. Diagnostika i antimikrobnaya terapiya infektsiy, vyzvannykh polirezistentnymi mikroorganizmami [Diagnosis and antimicrobial therapy of infections caused by multidrug-resistant microorganisms]. Vestnik anesteziologii i reanimatologii - Bulletin of Anesthesiology and Resuscitation, 2020, No. 17 (1), pp. 52-83.
2. Zabelin M.V., Popugaev K.A., Nesterova E.A. Diagnostika i intensivnaya terapiya vnutribryushnoj gipertenzii [Diagnosis and intensive care of intra-abdominal hypertension]. Annaly Khirurgii - Annals of Surgery, 2018, No. 23 (2), pp. 81-91.
3. Kozlov V.K. Disfunktsiya immunnoy sistemy v patogeneze sepsisa [Immune system dysfunction in the pathogenesis of sepsis]. Obshchaya reanimatologiya - General resuscitation, 2005, No. 1 (4), pp. 65-76.
4. Mazurok V.A., Antonova I.V., Golovkin K.S. Enteropatii kriticheskikh sostoyaniy: kliniko-morfologicheskie obrazy, vozmozhnosti korrektsii [Enteropathies of critical states: clinical and morphological images, possibilities of correction]. Translyacionnaya medicina -Translational medicine, 2017, No. 3 (5), pp. 42-52.
5. Parovichnikova E. N., Savchenko V. G. Rossiyskie mnogotsentrovye issledovaniya po lecheniyu ostrykh leykozov [Russian multicenter studies on the treatment of acute leukemia]. Terapevticheskiy arkhiv - Therapeutic Archive, 2019, No. 91 (7), pp. 4-15.
6. Saharov V.I. Mironov P.I., Ruslyakova I.A. Problemy otsenki tyazhesti sostoyaniya pozhilykh patsientov s vnebolnichnoy pnevmoniey, vyzvannoy Klebsiella pneumoniae [Problems in assessing the severity of elderly patients with community-acquired pneumonia caused by Klebsiella pneumoniae]. Vestnik anesteziologii i reanimatologii – Bulletin of Anesthesiology and Resuscitation, 2020, No. 17 (6), pp. 45-53.
7. Chuchalin A.G. Sinkopalnikov A.I., Kozlov R.S. Klinicheskie rekomendatsii po diagnostike, lecheniyu i profilaktike tyazheloy vnebolnichnoy pnevmonii u vzroslykh [Clinical guidelines for the diagnosis, treatment, and prevention of severe community-acquired pneumonia in adults]. Klinicheskaya mikrobiologiya i antimikrobnaya himioterapiya – Clinical Microbiology and Antimicrobial Chemotherapy, 2015, No. 17 (2), pp. 84-126.
8. Shestopalov A.E., Popova T.S. Patofiziologiya sindroma kishechnoy nedostatochnosti. Intensivnaya terapiya. Natsionalnoe rukovodstvo [Pathophysiology of intestinal failure syndrome Intensive care. National Guide]. 2017. pp. 574-579
9. Corrêa L.C. Predictors of mortality among patients with acute leukemias admitted to an intensive care unit specialized in patients with hematological disease at a Brazilian hospital. Hematology, Transfusion and Cell Therapy, 2020, No. 42, pp. 33-9.
10. Evans L. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intensive care medicine. 2021, No. 47 (11), pp. 1181-1247.
11. Iba T. Sepsis-associated disseminated intravascular coagulation and its differential diagnoses. Journal of Intensive Care, 2019, No. 7 (1), pp. 1-13.
12. Leaphart C.L., Tepas J.J. The gut is a motor of organ system dysfunction. Surgery, 2007, No. 141 (5), pp. 563-69.
13. Pagano L. Carbapenemase-producing Klebsiella pneumoniae and hematologic malignancies. Emerging infectious diseases, 2014, No. 20 (7), pp. 1235.
14. Ravioli S. Prevalence and impact on outcome of sodium and potassium disorders in patients with community-acquired pneumonia: A retrospective analysis. European journal of internal medicine, 2021, No. 85, pp. 63-7.
15. Rhodes A. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Intensive care medicine, 2017, No. 43 (3), pp. 304-77.
16. Tzouvelekis L.S. Carbapenemases in Klebsiella pneumoniae and other Enterobacteriaceae: an evolving crisis of global dimensions. Clinical microbiology reviews, 2012, No. 25 (4), pp. 682-707.
Review
For citations:
Saharov V.I., Mironov P.I., Lutfarakhmanov I.I., Ikromov T.Sh. Features of the clinical course of severe community-acquired pneumonia caused by Klebsiella pneumoniae in patients with acute leukemia. Health care of Tajikistan. 2022;(4):76-82. (In Russ.) https://doi.org/10.52888/0514-2515-2022-355-4-76-82
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