Wu Cuiyun, Zheng Lin, Yao Jie
Department of Clinical Laboratory, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, People's Republic of China.
Department of Laboratory Medicine and Medical Research Center, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, People's Republic of China.
Infect Drug Resist. 2022 May 3;15:2383-2391. doi: 10.2147/IDR.S362723. eCollection 2022.
Carbapenem-resistant (CRKP) infection is associated with high mortality and has become a major public problem threatening patients. This study aimed to explore risk factors for death in patients with (KP) and identify risk factors for CRKP infection.
The study retrospectively analyzed clinical characteristics and microbiological data from patients infected with KP from January 2019 to October 2021 to identify risk factors and mortality, using multivariate logistic regression analysis and Cox regression analysis.
A total of 214 KP inpatients were enrolled in our study. The in-hospital mortality rate was significantly higher in patients infected with CRKP (13/68, 19.12%) than carbapenem-susceptible KP (CSKP) (2/146, 1.37%) and the difference was statistically significant (P= 0.03). Multivariate Cox regression analysis showed CRKP isolation (HR 12.26, 95% CI 2.43-61.68, P = 0.002), lower TP (HR 10.50, 95% CI 1.33-82.76, P = 0.03), antibiotic days of therapy >15 (HR 0.08, 95% CI 0.01-0.56, P= 0.01) and length of stay (LOS) (HR 0.03, 95% CI 0.002-0.61, P= 0.02) were independent risk factors for death from KP. Additionally, intensive care unit (ICU) stay (OR 21.69, 95% CI 4.50-118.76, P< 0.001) and previous carbapenem exposure (OR 5.26, 95% CI 1.38-21.19, P= 0.02) are independent risk factors for CRKP.
Our findings showed that patients infected with CRKP have a higher in-hospital mortality rate. Identifying the independent risk factors for CRKP infection may contribute to the management of CRKP and reduce the mortality of KP patients.
耐碳青霉烯类肺炎克雷伯菌（CRKP）感染与高死亡率相关，已成为威胁患者的主要公共卫生问题。本研究旨在探讨肺炎克雷伯菌（KP）患者的死亡危险因素，并确定CRKP感染的危险因素。
本研究回顾性分析了2019年1月至2021年10月期间感染KP患者的临床特征和微生物学数据，采用多因素逻辑回归分析和Cox回归分析来确定危险因素和死亡率。
本研究共纳入214例KP住院患者。CRKP感染患者的院内死亡率（13/68，19.12%）显著高于碳青霉烯类敏感KP（CSKP）患者（2/146，1.37%），差异有统计学意义（P = 0.03）。多因素Cox回归分析显示，CRKP分离（HR 12.26，95%CI 2.43 - 61.68，P = 0.002）、较低的总蛋白（TP）（HR 10.50，95%CI 1.33 - 82.76，P = 0.03）、抗生素治疗天数>15天（HR 0.08，95%CI 0.01 - 0.56，P = 0.01）和住院时间（LOS）（HR 0.03，95%CI 0.002 - 0.61，P = 0.02）是KP患者死亡的独立危险因素。此外，入住重症监护病房（ICU）（OR 21.69，95%CI 4.50 - 118.76，P < 0.001）和既往碳青霉烯类药物暴露（OR 5.26，95%CI 1.38 - 21.19，P = 0.02）是CRKP的独立危险因素。
我们的研究结果表明，CRKP感染患者的院内死亡率较高。确定CRKP感染的独立危险因素可能有助于CRKP的管理，并降低KP患者的死亡率。
