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碳青霉烯类耐药肺炎克雷伯菌颅内感染死亡的影响因素。

Factors influencing mortality in intracranial infections caused by carbapenem-resistant Klebsiella Pneumoniae.

机构信息

Department of General Practice, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.

Department of Neurosurgical Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.

出版信息

Sci Rep. 2024 Sep 5;14(1):20670. doi: 10.1038/s41598-024-71660-4.

Abstract

It remains that intracranial infection has an alarming mortality and morbidity. Klebsiella pneumoniae (KP) have increasingly been isolated in ventriculitis and meningitis episodes. Intracranial infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) account for high mortality. To understand its clinical impact and related risk factors accurately are crucial in the management of bacterial intracranial infection. The retrospective study aimed to delineate the clinical risk of death from intracranial infection and analyze the risk factors. A total of 176 Klebsiella pneumoniae intracranial infectious patients were available to divide into CRKP group and carbapenem-susceptive Klebsiella Pneumoniae (CSKP) group. We performed survival analysis and estimate the time-varying effects of CRKP and CSKP infection on 30-day mortality. Infectious patients caused by CSKP was associated with lower mortality than CRKP group. The risk factors associated with death from intracranial infection caused by Klebsiella pneumoniae included SOFA scores, ventilator therapy, CRKP, and heart failure. Longer hospital stays are independently associated with lower mortality rates. Intracranial infection caused by CRKP was associated with excess mortality. Complex comorbidities mean higher mortality. Active supportive treatment is required for complicated patients with intracranial infections caused by carbapenem-resistant Klebsiella pneumoniae.

摘要

颅内感染仍然具有令人震惊的死亡率和发病率。肺炎克雷伯菌(KP)越来越多地从脑室炎和脑膜炎发作中分离出来。耐碳青霉烯类肺炎克雷伯菌(CRKP)引起的颅内感染死亡率很高。准确了解其临床影响和相关危险因素对于细菌性颅内感染的治疗至关重要。本回顾性研究旨在描述颅内感染的死亡临床风险,并分析相关危险因素。共纳入 176 例肺炎克雷伯菌颅内感染患者,分为 CRKP 组和碳青霉烯敏感肺炎克雷伯菌(CSKP)组。我们进行了生存分析,并估计了 CRKP 和 CSKP 感染对 30 天死亡率的时变影响。CSKP 引起的感染性患者死亡率低于 CRKP 组。与颅内感染相关的死亡危险因素包括 SOFA 评分、呼吸机治疗、CRKP 和心力衰竭。住院时间延长与较低的死亡率独立相关。CRKP 引起的颅内感染与死亡率升高有关。复杂的合并症意味着更高的死亡率。需要对耐碳青霉烯类肺炎克雷伯菌引起的颅内感染的复杂患者进行积极的支持性治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b38/11377438/e7b0a4575b4a/41598_2024_71660_Fig1_HTML.jpg

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