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 33
- Downloads 1
Clinical value analysis of simple resection of pancreatic solid pseudopapillary tumor
[Objective] To explore the clinical application value of simple resection in the treatment of pancreatic solid pseudopapillary tumor(SPT). [Methods] Retrospective analysis of clinical and follow-up data of pancreatic SPT...
Exosomes research in pathophysiology of peritoneal metastatic gastric cancer
Review and prospect of neoadjuvant chemoradiotherapy combined with immunotherapy in locally advanced rectal cancer
For locally advanced rectal cancer (LARC), the standard treatment of neoadjuvant chemoradiotherapy (nCRT) followed by total mesorectal excision (TME) leaded to limited tumor regression grade and organ preservation rate,...
Minimally invasive surgery facilitates surgical treatment of obesity and metabolic diseases
The prevalence and social burden of obesity and metabolic diseases are increasing. Multidisciplinary diagnosis and treatment, including surgical treatment, can effectively improve the condition of obesity and metabolic d...
Current status of minimally invasive surgery of gastroesophageal reflux disease
Gastroesophageal reflux disease (GERD) is one of the common gastrointestinal diseases. The treatment options for GERD includes lifestyle changes, medication, and surgery. With the development of surgical technology, mini...