Abstract:

Objective: To evaluate the clinical characteristics and risk factors for mortality of bloodstream infections of Carbapenem-resistant Klebsiella pneumonia(CRKP). Methods The electronic medical records of the patients with CRKP bloodstream infection in Ruijin hospital in Shanghai from January 2017 to June 2019 were reviewed and analyzed retrospectively. The patients were divided into survival group and death group according to the clinical endpoint of 30 d after infection, and their clinical characteristics and risk factors for mortality were analyzed. Results A total of 74 patients with CRKP bloodstream infection were enrolled, and the mortality rate was 55.4%. The independent risk factors for mortality within 30 d were acute physiology and chronic health evaluation (APACHE) Ⅱscore≥16.5 [odds ratio (OR)=1.118, 95% confidence interval(CI): 1.012-1.236, P=0.029], and septic shock(OR=1.52, 95% CI: 3.002-52.227, P=0.001). Conclusions The patients with CRKP bloodstream infection have a high mortality rate. The higher APACHEⅡ score is, the greater risk of mortality will be. For each additional point in the score, the risk of death increased 11.8%. The risk of death in the patients with septic shock is 12.52 times higher than that in higher than without septic shock.

Key words: Bloodstream infection, Carbapenem-resistant Klebsiella pneumoniae, Risk factors for mortality, Acute physiology and chronic health evaluation