Department of General Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou Key Laboratory of Sepsis, Henan Key Laboratory of Critical Care Medicine, Zhengzhou, China.
Department of Intensive Care Unit, Lankao People's Hospital, Kaifeng, China.
Front Cell Infect Microbiol. 2020 Nov 9;10:577244. doi: 10.3389/fcimb.2020.577244. eCollection 2020.
The clinical prognosis of Klebsiella pneumoniae() bloodstream infection is poor, and the prevalence of drug-resistant bacteria makes clinical anti-infective treatment more challenging. This retrospective study evaluated the epidemiological characteristics of patients with , the risk factors for drug-resistant bacterial infection and death, and analyzed treatment options.
Clinical data of 297 patients diagnosed with bacteremia between June 2014 and June 2019 were collected.
Intensive care unit hospitalization history, operation history, recent antibiotic use history, mechanical ventilation, and number of days hospitalized before bloodstream infection were found to be independent risk factors for drug-resistant bacterial infection. The risk of death for carbapenem-resistant infection was 2.942 times higher than that for carbapenem-sensitive infection. For extensively drug-resistant bacteremia patients, the mortality rate of combined anti-infective therapy was lower.
Clinicians should pay attention to patients with high-risk drug-resistant bacteria infection and administer timely anti-infection treatment. The findings of this study may provide some suggestions for early identification and standardized treatment of patients with bacteremia.
肺炎克雷伯菌血流感染的临床预后较差，耐药菌的流行使得临床抗感染治疗更具挑战性。本回顾性研究评估了肺炎克雷伯菌血流感染患者的流行病学特征、耐药菌感染和死亡的危险因素，并分析了治疗选择。
收集了 2014 年 6 月至 2019 年 6 月期间 297 例确诊为肺炎克雷伯菌菌血症患者的临床资料。
重症监护病房住院史、手术史、近期抗生素使用史、机械通气和血流感染前住院天数是耐药菌感染的独立危险因素。耐碳青霉烯类肺炎克雷伯菌感染的死亡风险是碳青霉烯类敏感肺炎克雷伯菌感染的 2.942 倍。对于广泛耐药肺炎克雷伯菌菌血症患者，联合抗感染治疗的死亡率较低。
临床医生应注意高风险耐药菌感染患者，并及时进行抗感染治疗。本研究结果可能为早期识别和规范治疗肺炎克雷伯菌菌血症患者提供一些建议。
