Clinical features and risk factors for mortality in patients with Klebsiella pneumoniae bloodstream infections.

IF 1.4 4区医学 Q4 INFECTIOUS DISEASES

Journal of Infection in Developing Countries Pub Date : 2024-06-30 DOI:10.3855/jidc.18649

Panpan Xu, Xijiang Zhang, Qingqing Chen, Qin Si, Xinhua Luo, Chuming Zhang, Zongguang He, Ronghai Lin, Cheng Zheng

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引用次数: 0

Abstract

Introduction: 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.

Methodology: 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.

Results: 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.

Conclusions: 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.

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肺炎克雷伯氏菌血流感染患者的临床特征和死亡风险因素。

导言：肺炎克雷伯菌（K. pneumoniae）血流感染（KP-BSIs）因其高发病率和致死率而受到广泛关注。本研究旨在调查 KP-BSIs 的临床特征和导致死亡的风险因素：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 KP-BSIs 患者均被纳入研究，其临床数据均来自电子病历：共纳入 145 例患者（存活组 121 例，非存活组 24 例）。非存活组的下呼吸道感染比例高于存活组（33.3% 对 12.4%）（P < 0.05）。与存活组相比，非存活组肺炎克氏菌耐多药（MDR）菌株的比例更高（41.7% 对 16.5%）（P < 0.05）。多变量分析显示，序贯器官衰竭评估（SOFA）评分大于6.5（OR，13.71；95% CI，1.05-179.84）、入住重症监护室（ICU）（OR，2.27；95% CI，0.26-19.61）和消化道出血（OR，19.97；95% CI，1.11-361.02）是KP-BSI患者死亡的独立风险因素：结论：在所有KP-BSI中，肺炎克雷伯菌有很高的比例来自下呼吸道感染，而且有很高比例的肺炎克雷伯菌是MDR菌，但死亡率并未受到影响。SOFA 评分 > 6.5、入住重症监护室和消化道出血是导致 KP-BSI 患者死亡的独立风险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection in Developing Countries INFECTIOUS DISEASES-

CiteScore

3.70

自引率

5.30%

发文量

239

审稿时长

4-8 weeks

期刊介绍： The Journal of Infection in Developing Countries (JIDC) is an international journal, intended for the publication of scientific articles from Developing Countries by scientists from Developing Countries. JIDC is an independent, on-line publication with an international editorial board. JIDC is open access with no cost to view or download articles and reasonable cost for publication of research artcles, making JIDC easily availiable to scientists from resource restricted regions.