Five-year change of prevalence and risk factors for infection and mortality of carbapenem-resistant Klebsiella pneumoniae bloodstream infection in a tertiary hospital in North China
机构：[1]Department of Infectious Diseases, The Second Hospital of Hebei Medical University, No. 215 Heping Western Road, Xinhua District, Shijiazhuang 050000, China[2]Department of Laboratory Medicine, The Second Hospital of Hebei Medical University, No. 215 Heping Western Road, Shijiazhuang 050000, China[3]Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital, No.12 Jiankang Road, Shijiazhuang 050000, China.河北医科大学第四医院[4]Department of Pediatrics, The Second Hospital of Hebei Medical University, No. 215 Heping Western Road, Shijiazhuang 050000, China.
Background There are few studies focused on carbapenem-resistant Klebsiella pneumoniae (CRKP) bloodstream infection (BSI). The aim of this study is to identify the prevalence and risk factors for infection and mortality of CRKP BSI. Methods Susceptibility of Klebsiella pneumoniae (KP) isolated from blood samples and the proportion of CRKP were recorded annually. One hundred sixty-four patients with CRKP and 328 with carbapenem-susceptible Klebsiella pneumoniae (CSKP) BSI were categorized as the case group and control group to identify risk factors for CRKP infection and mortality by univariable analysis and multivariable logistic-regression analysis. Results The proportion and mortality of CRKP BSI increased significantly, with the percentage of KP in BSI increasing from 7 to 12% from 2014 to 2019 with a concomitant resistance to meropenem increasing from 16.7 to 41.8%. Compared with CSKP group, patients in CRKP group had longer hospitalization time before bacteremia (median 14 vs 4, P < 0.001) and longer total hospitalization time (median 31 vs 19, P < 0.001). The proportion of admission to ICU was higher (70.7% vs 17.7%, P < 0.001), and APACHE II score was higher (median 12 vs 8, P < 0.001). The mortality in CRKP group was 43.9% (72/164), while 14.9% (49/328) in CSKP group (p < 0.001). KP detection in other sites(P = 0.036, OR 1.964), blood purification(P = 0.018, OR 3.326), bronchoscopy(P = 0.011, OR 5.423), surgery (P = 0.001, OR 3.084), carbapenem use(P = 0.001, OR 3.395), tigecycline use(P = 0.006, OR 4.595) were independent risk factors for CRKP BSI. Previous hospitalization (P = 0.048, OR 2.755), long hospitalization (P = 0.003, OR 1.035), bone marrow puncture (P = 0.037, OR3.856), use of beta-lactamase inhibitor (P = 0.005, OR 3.890) were independent risk factors for mortality in CRKP BSI. Conclusion The prevalence and mortality of CRKP BSI are still increasing. Timely treatment of KP infection in other site, strengthening the hospital infection control of blood purification, bronchoscopy and surgery, control the use of carbapenem and tigecycline, may help to prevent CRKP BSI. More preventative hospital resources are needed for severely ill patients with prolonged hospitalizations and intensive care.
第一作者机构：[1]Department of Infectious Diseases, The Second Hospital of Hebei Medical University, No. 215 Heping Western Road, Xinhua District, Shijiazhuang 050000, China
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推荐引用方式(GB/T 7714)：
Li Yuanyuan,Li Jihong,Hu Tong,et al.Five-year change of prevalence and risk factors for infection and mortality of carbapenem-resistant Klebsiella pneumoniae bloodstream infection in a tertiary hospital in North China[J].ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL.2020,9(1):doi:10.1186/s13756-020-00728-3.
APA：
Li, Yuanyuan,Li, Jihong,Hu, Tong,Hu, Jia,Song, Ning...&Chen, Yuan.(2020).Five-year change of prevalence and risk factors for infection and mortality of carbapenem-resistant Klebsiella pneumoniae bloodstream infection in a tertiary hospital in North China.ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL,9,(1)
MLA：
Li, Yuanyuan,et al."Five-year change of prevalence and risk factors for infection and mortality of carbapenem-resistant Klebsiella pneumoniae bloodstream infection in a tertiary hospital in North China".ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL 9..1(2020)
