Risk factors and prognosis of carbapenem-resistant Klebsiella pneumoniae bloodstream infection in ICU patients: a report of 81 cases
Journal Title: Journal of Surgery : Concepts & Practice - Year 2023, Vol 28, Issue 5
Abstract
[Objective] Comprehensive mortality risk analyses and therapeutic assessment in real-world practice are beneficial to guide individual treatment in patients with Carbapenem-resistant Klebsiella pneumoniae bloodstream infections (CRKP-BSI). [Methods] Retrospective analysis of the clinical characteristics of 81 CRKP-BSI patients in our intensive care unit from July 2016 to June 2020, to indentify the risk factors of death and treatment effects of different antibiotic regimens. [Results] In 81 CRKP-BSI cases, the majority source were from abdominal and respiratory, accounting for 56.79% (46 cases) and 22.22% (18 cases), respectively. The 28-day mortality and hospitalization mortality of CRKP-BSI were 54.32% (44 cases) and 65.43% (53 cases). Multivariate regression analysis suggested that biliary tract disease before admission (P=0.026) and increased SOFA score at the onset of BSI (P=0.006) were independent risk factors for 28-day mortality. There was no statistically significant difference in 28-day mortality between the groups of antibiotic treatment based on tigecycline (44 cases) and polymyxin B (26 cases) [56.82% (25/44) vs. 57.69% (15/26), P=0.943]. Patients were evaluated based on their age (≤ 65 years vs. >65 years), gender, body mass index (≤25 kg/m2vs. >25 kg/m2), and APACHE Ⅱ score (≤20 vs. >20), the use of renal replacement therapy and mechanical ventilation, there was no difference in the mortality among each subgroup. [Conclusions] Biliary tract disease before admission and SOFA score were independent risk factors for 28-day mortality. There was no significant difference outcomes between tigecycline- and polymyxin B-based therapy.
Authors and Affiliations
Meng LIU, Wen XU, Yunqi DAI, Ruoming TAN, Jialin LIU, Feifei GU, Erzhen CHEN, Xiaoli WANG, Hongping QU, Yuzhen QIU
Keywords
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- EP ID EP750914
- DOI 10.16139/j.1007-9610.2023.05.11
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