Original article

Analysis of risk factors for mortality in patients with bloodstream infection of Carbapenem-resistant Klebsiella pneumonia

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  • 1. Department of Respiratory and Critical Care Medicine, Renhe Hospital, Baoshan District, Shanghai 200431, China
    2. Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2021-11-04

  Online published: 2022-07-25

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.

Cite this article

BIAN Xiujuan, BAO Zhiyao, CHEN Hong, CHENG Luxiao, SHI Baoping . Analysis of risk factors for mortality in patients with bloodstream infection of Carbapenem-resistant Klebsiella pneumonia[J]. Journal of Internal Medicine Concepts & Practice, 2022 , 17(01) : 73 -77 . DOI: 10.16138/j.1673-6087.2022.01.014

References

[1] 胡付品, 郭燕, 朱德妹, 等. 2020年CHINET三级医院细菌耐药监测[J]. 中国感染与化疗杂志, 2021, 21(4): 377-387.
[2] 吴湜, 胡付品, 蒋晓飞, 等. 2019 年上海市三级医院细菌耐药监测[J]. 中国感染与化疗杂志, 2021, 21(1): 1-9.
[3] Zhang S, Yang Z, Sun L, et al. Clinical observation and prognostic analysis of patients with Klebsiella pneumoniae bloodstream infection[J]. Front Cell Infect Microbiol, 2020, 11(9): 577244.
[4] 陈燕, 赵瑞红, 涂盛, 等. 耐碳青霉烯类肺炎克雷伯菌血流感染危险因素及预后分析[J]. 中国微生态学杂志, 2019, 31(12): 1424-1430.
[5] Hsu JY, Chuang YC, Wang JT, et al. Healthcare-associated Carbapenem-resistant Klebsiella pneumoniae bloodstream infections: risk factors, mortality, and antimicrobial susceptibility, 2017-2019[J]. J Formos Med Assoc, 2021, 120(11): 1994-2002.
[6] Liu KS, Tong YS, Lee MT, et al. Risk factors of 30-day all-cause mortality in patients with Carbapenem-resistant Klebsiella pneumoniae bloodstream infection[J]. J Pers Med, 2021, 11(7):616.
[7] 孙武铭, 周华, 沈丽莎, 等. 碳青霉烯类抗生素耐药肺炎克雷伯菌血流感染不同抗感染治疗方案的疗效与安全性[J]. 中华内科杂志, 2019, 58(8): 566-571.
[8] 曹培, 杨勇, 张志勇. 耐碳青霉烯类肺炎克雷伯菌血流感染危险因素及预后分析[J]. 医药导报, 2021, 40(8): 1048-1052.
[9] 王丹纯, 吴映娥, 李佳佳, 等. 肺炎克雷伯菌血流感染合并糖尿病的临床特征及耐药性分析[J]. 汕头大学医学院学报, 2021, 34(1): 40-44.
[10] Zhang P, Wang J, Hu H, et al. Clinical characteristics and risk factors for bloodstream infection due to Carbapenem-resistant Klebsiella pneumoniae in patients with hematologic malignancies[J]. Infect Drug Resist, 2020, 13(9): 3233-3242.
[11] Chang H, Wei J, Zhou W, et al. Risk factors and mortality for patients with bloodstream infections of Klebsiella pneumoniae during 2014-2018: clinical impact of carbapenem resistance in a large tertiary hospital of China[J]. J Infect Public Health, 2020, 13(5): 784-790.
[12] Zhang H, Guo Z, Chai Y, et al. Risk factors for and clinical outcomes of Carbapenem-resistant Klebsiella pneumoniae nosocomial infections: a retrospective study in a tertiary hospital in Beijing, China[J]. Infect Drug Resist, 2021, 14: 1393-1401.
[13] 降钙素原在成人下呼吸道感染性疾病分级管理中的应用专家共识组. 降钙素原在成人下呼吸道感染性疾病分级管理中的应用专家共识[J]. 中华急诊医学杂志, 2021, 30(4): 393-401.
[14] Falcone M, Bassetti M, Tiseo G, et al. Time to appropriate antibiotic therapy is a predictor of outcome in patients with bloodstream infection caused by KPC-producing Klebsiella pneumoniae[J]. Crit Care, 2020, 24(1): 29.
[15] Brescini L, Morroni G, Valeriani C, et al. Clinical and epidemiological characteristics of KPC-producing Klebsiella pneumoniae from bloodstream infections in a tertiary referral center in Italy[J]. BMC Infect Dis, 2019, 19(1): 611.
[16] Wu X, Shi Q, Shen S, et al. Clinical and bacterial characteristics of Klebsiella pneumoniae affecting 30-day mortality in patients with bloodstream infection[J]. Front Cell Infect Microbiol, 2021, 11: 688989.
[17] Zhou C, Jin L, Wang Q, et al. Bloodstream infections caused by Carbapenem-resistant enterobacterales: risk factors for mortality, antimicrobial therapy and treatment outcomes from a prospective multicenter study[J]. Infect Drug Resist, 2021, 14: 731-742.
[18] Papadimitriou-Olivgeris M, Bartzavali C, Georgakopoulou A, et al. Mortality of pandrug-resistant Klebsiella pneumoniae bloodstream infections in critically ill patients[J]. Antibiotics (Basel), 2021, 10(1): 76.
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