Diabetes and Liver Abscess Are Predictors of Hypervirulent K pneumoniae Infection

Diabetes and liver abscess are significant predictors for the occurrence of hypervirulent Klebsiella pneumoniae infection, according to findings published in The Journal of Hospital Infection. 

Researchers conducted a systematic review and meta-analysis to identify and evaluate predictors of hypervirulent K pneumoniae infection. The analysis included patient data captured between January 2000 and March 2022, and only clinical trials and cohort, case-control, and cross-sectional studies were included in the review. The primary outcome measures were risk factors for hypervirulent K pneumoniae infection. Cochran Q test was used to assess study heterogeneity, and significant predictors were evaluated via multivariate analysis. 

The final analysis included 11 studies, representing 1392 patients with K pneumoniae infection. Of the infected patients, 592 (42.8%) had hypervirulent strains. The most commonly reported infections included pneumonia, bloodstream, and urinary tract infections.

Analysis of pooled data indicated that both diabetes (risk ratio [RR], 2.61; 95% CI, 1.79-3.80) and liver abscess (RR, 9.04; 95% CI, 2.58-31.72) were significant predictors of hypervirulent K pneumoniae infection (both P <.001; I², <50%).

In light of these findings, the researchers noted that good glycemic control may decrease both the risk for septic metastatic complications and the prevalence of hypervirulent K pneumoniae infection.

Limitations of this analysis include potential selection bias as most studies had retrospective designs; variations in infection types and the definition of hypervirulence factors; and the predominance of studies conducted in China. 

According to the researchers, “[T]his research highlights the urgent need for increasing clinical awareness of the management of hvKp [hypervirulent K pneumoniae] infections and will lead to the prevention of hvKp infection exacerbation and improvement of the prognosis.”