Li Jing, Wu Shunjun, Zhang Huanhuan, Guo Xingxing, Meng Wanting, Zhao Heng, Song Liqiang
Department of Respiratory and Critical Care Medicine, Xijing Hospital of Air Force Medical University, Xi'an 710032, China.
Antibiotics (Basel). 2025 Jul 18;14(7):721. doi: 10.3390/antibiotics14070721.
: There is a scarcity of studies on multisite infections (MSIs) caused by carbapenem-resistant Klebsiella pneumoniae (CRKP). The primary objectives of this research were to determine the clinical characteristics of CRKP MSI, and the risk factors of infection and mortality. : Patients with a CRKP bloodstream infection (BSI) were enrolled retrospectively between January 2017 and December 2021 in Xijing Hospital, China. The risk factors for CRKP MSI and mortality were evaluated. The demographic data, clinical and microbiological characteristics, therapy and outcomes were analyzed. : Among 101 patients, 74.3% (75/101) had a diagnosis of CRKP MSI, while 25.7% (26/101) of CRKP non-MSI. The overall case fatality rate was 42.6% (43/101). Multivariate analysis indicated that previous surgery (OR 3.971, 95% CI 1.504-10.480, = 0.005) and ICU admission (OR 3.322, 95% CI 1.252-8.816, = 0.016) were independent risk factors for CRKP MSI. ICU admission (OR 4.765, 95% CI 1.192-19.054, = 0.027), a Pitt bacteremia score (PBS) > 4 (OR 3.820, 95% CI 1.218-11.983, = 0.022) and thrombocytopenia (OR 8.650, 95% CI 2.573-29.007, < 0.001) were independent risk factors for mortality due to CRKP MSI. : Our findings confirmed that CRKP MSIs were associated with poorer outcomes. To improve prognosis, early screening of individuals at the highest risk is vital.
关于耐碳青霉烯类肺炎克雷伯菌(CRKP)引起的多部位感染(MSIs)的研究较少。本研究的主要目的是确定CRKP MSI的临床特征以及感染和死亡的危险因素。:2017年1月至2021年12月期间,中国西京医院对患有CRKP血流感染(BSI)的患者进行了回顾性研究。评估了CRKP MSI和死亡的危险因素。分析了人口统计学数据、临床和微生物学特征、治疗方法及结果。:101例患者中,74.3%(75/101)被诊断为CRKP MSI,而25.7%(26/101)为CRKP非MSI。总体病死率为42.6%(43/101)。多因素分析表明,既往手术(OR 3.971,95%CI 1.504 - 10.480,P = 0.005)和入住重症监护病房(ICU)(OR 3.322,95%CI 1.252 - 8.816,P = 0.016)是CRKP MSI的独立危险因素。入住ICU(OR 4.765,95%CI 1.192 - 19.054,P = 0.027)、皮特菌血症评分(PBS)>4(OR 3.820,95%CI 1.218 - 11.983,P = 0.022)和血小板减少(OR 8.650,95%CI 2.573 - 29.007,P < 0.001)是CRKP MSI导致死亡的独立危险因素。:我们的研究结果证实,CRKP MSI与较差的预后相关。为改善预后,对高危个体进行早期筛查至关重要。