Department of Critical Care Medicine, Taizhou Municipal Hospital, Taizhou, Zhejiang 318000, China.
Department of Critical Care Medicine, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang 318050, China.
J Infect Dev Ctries. 2024 Jun 30;18(6):843-850. doi: 10.3855/jidc.18649.
Concern about Klebsiella pneumoniae (K. pneumoniae) bloodstream infections (KP-BSIs) is widespread because of their high incidence and lethality. The aim of this study was to investigate the clinical features of, and risk factors for mortality caused by KP-BSIs.
This was a single-center retrospective observational study performed between 1 January 2019 and 31 December 2021, at a tertiary hospital. All patients with KP-BSIs were enrolled and their clinical data were retrieved from electronic medical records.
A total of 145 patients were included (121 in the survival group and 24 in the non-survival group). There was a higher proportion of lower respiratory tract infections in the non-survival group than in the survival group (33.3% vs. 12.4%) (p < 0.05). There was a higher proportion of multi drug resistant (MDR) strains of K. pneumoniae in the non-survival group than in the survival group (41.7% vs. 16.5%) (p < 0.05). Multivariate analysis revealed that sequential organ failure assessment (SOFA) score > 6.5 (OR, 13.71; 95% CI, 1.05-179.84), admission to the intensive care unit (ICU) (OR, 2.27; 95% CI, 0.26-19.61) and gastrointestinal bleeding (OR, 19.97; 95% CI, 1.11-361.02) were independent risk factors for death in patients with KP-BSIs.
Among all KP-BSIs, a high proportion of K. pneumoniae originated from lower respiratory tract infections, and a high proportion of K. pneumoniae were MDR; however, mortality was not influenced. SOFA score > 6.5, admission to the ICU, and gastrointestinal bleeding were independent risk factors for death in patients with KP-BSI.
由于肺炎克雷伯菌（K. pneumoniae）血流感染（KP-BSIs）的高发病率和致死率，人们普遍对其表示担忧。本研究旨在调查 KP-BSIs 的临床特征和死亡相关的危险因素。
这是一项单中心回顾性观察研究，于 2019 年 1 月 1 日至 2021 年 12 月 31 日在一家三级医院进行。所有患有 KP-BSIs 的患者均被纳入研究，并从电子病历中检索其临床数据。
共纳入 145 例患者（存活组 121 例，非存活组 24 例）。非存活组下呼吸道感染的比例高于存活组（33.3%比 12.4%）（p < 0.05）。非存活组耐多药（MDR）肺炎克雷伯菌的比例高于存活组（41.7%比 16.5%）（p < 0.05）。多因素分析显示，序贯器官衰竭评估（SOFA）评分>6.5（OR，13.71；95%CI，1.05-179.84）、入住重症监护病房（ICU）（OR，2.27；95%CI，0.26-19.61）和胃肠道出血（OR，19.97；95%CI，1.11-361.02）是 KP-BSIs 患者死亡的独立危险因素。
在所有 KP-BSIs 中，有相当比例的肺炎克雷伯菌来源于下呼吸道感染，且有相当比例的肺炎克雷伯菌为耐多药菌；然而，死亡率并未受此影响。SOFA 评分>6.5、入住 ICU 和胃肠道出血是 KP-BSI 患者死亡的独立危险因素。
