LI Hui 1,2 , ZHENG Yao 1,2 , YANG Xiang 1,2 , ZHANG Pingjie 1,2 , XIAO Wenyan 1,2 , YANG Min 1,2
  • 1. Department of Intensive Care Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, P.R.China;
  • 2. Department of Cardiopulmonary Resuscitation and Critical Care Laboratory, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, P.R.China;
YANG Min, Email: 456ym@163.com
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Objectives To identify the clinical characteristics and prognosis for CRKP (Carbapenem-resistant Klebsiella pneumonia, CRKP) infection among ICU patients in the Second Affiliated Hospital of Anhui Medical University. Methods We conducted a retrospectively analysis in which 19 patients infected by CRKP with another 21 CSKP (Carbapenem-sensitive Klebsiella pneumoniae, CSKP) infected patients from January 2017 to April 2018. Risk factors for CRKP infection were assessed. Results The lower respiratory tract is the most common site of CRKP infection in our department. CRKP infection was associated with several clinical symptoms, particularly a higher incidence of sepsis shock (χ2=8.338, P=0.004), more application of the combined medicine (χ2=26.3, P<0.001), prolonged hospital stays (χ2=–2.217, P=0.027) and more expenses on antibiotics (χ2=12.855, P=0.005), and the declined survival rates in 14 days (χ2=4.269, P=0.039) and 21 days (χ2 =5.647, P=0.017). The resistance rate of CRKP strains was high, however no resistance to tegafycline was found. The risk factors of CRKP infection included three generations of cephalosporin and/or hydrocarbonase antibiotics exposure (χ2 =6.388, P=0.041), exposure time of three generations of cephalosporin (U=–2.187, P=0.029), exposure time of hydrocarbonase antibiotics (U=–2.103, P=0.035), tracheal intubation (χ2=6.352, P=0.012), tracheotomy (χ2 =4.821, P=0.028), SOFA score (t=4.505, P<0.001) and Charlson comorbidity index (t=3.041, P=0.004). The SOFA score was the only factor independently associated with CRKP bacteremia (P=0.02). Conclusions CRKP infections in ICU directly affect the course of disease, survival time and treatment expenses of patients. Therefore, monitoring bacterial resistance, rational use of antibiotics, and protection of the immune function are of great significance for prevention and treatment of CRKP infection.

Citation: LI Hui, ZHENG Yao, YANG Xiang, ZHANG Pingjie, XIAO Wenyan, YANG Min. Clinical characteristics and prognosis of carbapenem-resistant Klebsiella pneumoniae infection of critical patients. Chinese Journal of Evidence-Based Medicine, 2019, 19(2): 129-134. doi: 10.7507/1672-2531.201809113 Copy

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