Yang Xin, Wang Yanjun, Zhao Siqi, Huang Xiaoya, Tian Bingxin, Yu Runli, Ding Qin
Department of Infectious Disease and Hepatic Disease, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China.
Heliyon. 2024 Mar 18;10(7):e28010. doi: 10.1016/j.heliyon.2024.e28010. eCollection 2024 Apr 15.
is a causative agent of bacterial meningitis in adults. However, there is little information regarding this infection. Therefore, this study comprehensively analyzed the clinical characteristics and prognosis of meningitis (KPM) patients.
The clinical data of adult hospitalized patients with KPM were retrospectively collected from January 2015 to December 2022. The clinical characteristics and antibiotic resistance of KPM were evaluated. Meanwhile, a set of logistic regression models was constructed to identify prognostic factors for death. These prognostic factors were subsequently combined to develop a nomogram for predicting the risk of in-hospital mortality in individual patients. Finally, the receiver operating characteristic curve and calibrate plot were utilized to verify the performance of the nomogram.
This study included 80 adult patients with KPM, 58 (72.5%) of whom were males. The mortality rate was 45%. Among them, 74 (92.5%) were diagnosed with healthcare-associated meningitis. Thirty-seven carbapenem-resistant (CRKP) strains were susceptible to tigecycline, polymyxin, and ceftazidime/avibactam. CRKP (OR = 9.825, 95%CI = 2.757-35.011, P < 0.001), length of stay (OR = 0.953, 95%CI = 0.921-0.986, P = 0.005), and C-reactive protein-to-prealbumin ratio (CRP/PA, OR = 3.053, 95%CI = 1.329-7.016, P = 0.009) were identified as predictive factors for mortality using multivariate logistic regression. Finally, a nomogram for death prediction was established. The area under the curve of this nomogram was 0.900 (95% CI = 0.828-0.971).
KPM is a fatal disease associated with high incidence of healthcare-associated infections and carbapenem resistance. Moreover, CRKP, length of stay, and CRP/PA were found to be independent predictors of mortality.
是成人细菌性脑膜炎的病原体。然而，关于这种感染的信息很少。因此，本研究全面分析了脑膜炎（KPM）患者的临床特征和预后。
回顾性收集2015年1月至2022年12月期间成年住院KPM患者的临床资料。评估KPM的临床特征和抗生素耐药性。同时，构建一组逻辑回归模型以确定死亡的预后因素。随后将这些预后因素结合起来，开发出用于预测个体患者院内死亡风险的列线图。最后，利用受试者工作特征曲线和校准图来验证列线图的性能。
本研究纳入了80例成年KPM患者，其中58例（72.5%）为男性。死亡率为45%。其中，74例（92.5%）被诊断为医疗相关脑膜炎。37株耐碳青霉烯类（CRKP）菌株对替加环素、多粘菌素和头孢他啶/阿维巴坦敏感。使用多因素逻辑回归分析，CRKP（OR = 9.825，95%CI = 2.757 - 35.011，P < 0.001）、住院时间（OR = 0.953，95%CI = 0.921 - 0.986，P = 0.005）和C反应蛋白与前白蛋白比值（CRP/PA，OR = 3.053，95%CI = 1.329 - 7.016，P = 0.009）被确定为死亡的预测因素。最后，建立了死亡预测列线图。该列线图的曲线下面积为0.900（95%CI = 0.828 - 0.971）。
KPM是一种致命疾病，与医疗相关感染和碳青霉烯耐药的高发生率相关。此外，CRKP、住院时间和CRP/PA被发现是死亡率的独立预测因素。
