Risk factors and prognosis of carbapenem-resistant Klebsiella pneumoniae bloodstream infection in ICU patients: a report of 81 cases
Journal Title: Journal of Surgery : Concepts & Practice - Year 2023, Vol 28, Issue 5
Abstract
[Objective] Comprehensive mortality risk analyses and therapeutic assessment in real-world practice are beneficial to guide individual treatment in patients with Carbapenem-resistant Klebsiella pneumoniae bloodstream infections (CRKP-BSI). [Methods] Retrospective analysis of the clinical characteristics of 81 CRKP-BSI patients in our intensive care unit from July 2016 to June 2020, to indentify the risk factors of death and treatment effects of different antibiotic regimens. [Results] In 81 CRKP-BSI cases, the majority source were from abdominal and respiratory, accounting for 56.79% (46 cases) and 22.22% (18 cases), respectively. The 28-day mortality and hospitalization mortality of CRKP-BSI were 54.32% (44 cases) and 65.43% (53 cases). Multivariate regression analysis suggested that biliary tract disease before admission (P=0.026) and increased SOFA score at the onset of BSI (P=0.006) were independent risk factors for 28-day mortality. There was no statistically significant difference in 28-day mortality between the groups of antibiotic treatment based on tigecycline (44 cases) and polymyxin B (26 cases) [56.82% (25/44) vs. 57.69% (15/26), P=0.943]. Patients were evaluated based on their age (≤ 65 years vs. >65 years), gender, body mass index (≤25 kg/m2vs. >25 kg/m2), and APACHE Ⅱ score (≤20 vs. >20), the use of renal replacement therapy and mechanical ventilation, there was no difference in the mortality among each subgroup. [Conclusions] Biliary tract disease before admission and SOFA score were independent risk factors for 28-day mortality. There was no significant difference outcomes between tigecycline- and polymyxin B-based therapy.
Authors and Affiliations
Meng LIU, Wen XU, Yunqi DAI, Ruoming TAN, Jialin LIU, Feifei GU, Erzhen CHEN, Xiaoli WANG, Hongping QU, Yuzhen QIU
Keywords
Related Articles
- EP ID EP750914
- DOI 10.16139/j.1007-9610.2023.05.11
- Views 34
- Downloads 1
Risk factors and prevention methods for post-ERCP pancreatitis
Endoscopic retrograde cholangio-pancreatography (ERCP) is one of the primary procedural techniques used for diagnosing biliary and pancreatic diseases. Post-ERCP pancreatitis (PEP) is the most common complication of ERCP...
Perioperative intensive care for cardiac surgery patients
The rapid development of perioperative intensive care in cardiac surgery has greatly improved the prognosis for patients undergoing major cardiovascular surgery. In the field of hemodynamics, besides traditional methods,...
Analysis and recognition of endoscopic treatment for cholelithiasis from the view of disease of pancreaticobiliary junction
Cholelithiasis is a common disease, which seriously endangers human health. The traditional treatment mainly depended on open cholecystectomy and biliary tract exploration. With the development of minimally invasive tech...
Liver perforation caused by modified biliary stent of nasobiliary duct：a case report
There are many cases of biliary stent migration. Generally, biliary stent migrates distally. While, biliary stent rarely migrates proximally. Here we reported the case of a 49-year-old woman who underwent robot assisted...
Risk factors and prognosis of carbapenem-resistant Klebsiella pneumoniae bloodstream infection in ICU patients: a report of 81 cases
[Objective] Comprehensive mortality risk analyses and therapeutic assessment in real-world practice are beneficial to guide individual treatment in patients with Carbapenem-resistant Klebsiella pneumoniae bloodstream inf...