医学
队列
肺炎克雷伯菌
内科学
感染控制
队列研究
碳青霉烯
克雷伯菌感染
重症监护医学
抗生素
微生物学
生物
生物化学
基因
大肠杆菌
作者
Tao Lou,Xiaoxing Du,Ping Zhang,Qiucheng Shi,Xinhong Han,Peng Lan,Rushuang Yan,Huangdu Hu,Yanfei Wang,Xueqing Wu,Yan Jiang,Yunsong Yu
标识
DOI:10.1016/j.jinf.2022.03.010
摘要
Objectives To elucidate the predictors of carbapenem-resistant Klebsiella pneumoniae (CRKP) infection and help clinicians better identify CRKP infection at an early stage. Methods We conducted a multicentre case–control study of 422 patients with CRKP infection and 948 with carbapenem-susceptible K. pneumoniae (CSKP) infection from March to July 2017. Binary logistic regression was used to identify risk factors for CRKP infection. The subgroups of CRKP respiratory infection, intra-abdominal infection, and bloodstream infection were also evaluated. Patients were followed up for 28 days. Independent risk factors for 28-day crude mortality of CRKP infection were analysed using Cox proportional hazards regression models. Results Longer stay of hospitalization, stay in the intensive care unit (ICU), previous exposure to antibacterial agents (especially carbapenems, quinolones, aminoglycosides, and tigecycline), invasive procedures, intravascular catheter use, tracheotomy, and admission to ICU in the preceding 90 days were risk factors for CRKP infection. Carbapenem exposure was the only common predictor of different types of CRKP infection. The 28-day crude mortality of CRKP infection was 24.2% and was independently associated with sex, admitted unit, and type of infection. Conclusions Strict policies for antibiotic use, cautious decisions regarding the implementation of invasive procedures, and careful management of patients with catheters, especially intravascular catheters, are necessary to handle CRKP infection.
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