Background: Bloodstream infection (BSI) caused by Klebsiella pneumoniae (KP), especially carbapenem-resistant KP (CRKP), results in high morbidity and mortality.
Aims: We aim to identify risk factors that associated with the mortality of patients with KP BSI, as well as predictors of developing CRKP BSI.
Results: In this retrospective cohort study, we examined 285 inpatients with BSI caused by KP in a tertiary hospital in China between 2014 and 2018, and 46 patients were infected with CRKP. We identified that hematological tumor (odds ratio (OR): 8.359, [95% CI: 2.162-33.721], P=0.002), CRKP isolation (OR: 7.766, [95% CI: 2.796-21.576], P=0.001), chronic lung disease (OR: 5.020, [95% CI: 1.275-19.768], P=0.020), and septic shock (OR: 4.591, [95% CI: 1.686-12.496], P=0.003) were independent risk factors for the death of KP BSI. A 28-day mortality of KP BSI score ranging from 0 to 22 was developed based on the above 4 independent variables. Our scoring system revealed that the 28-day mortality were 9.14%, 35.29%, 38.10 %, 75% and 100% for carriers with a score of 0, 5, 6-10, 11-13 and ≥14, respectively. Additionally, CRKP infection were independently associated with intensive care unit stay (OR: 5.506, [95% CI: 2.258-13.424], P=0.001), exposure to antifungals (OR: 4.679, [95% CI: 2.065-10.063], P=0.001), exposure to fluoroquinolones (OR: 2.892, [95% CI: 1.151-7.267], P=0.020), and the number of isolated bacterial species from the patient ≥ 3 (OR: 2.414, [95% CI: 1.306-4.463], P=0.005).
Conclusion: Our study may be useful for the reduction of the mortality of patients with KP BSI and the prevention of developing CRKP BSI in hospitals.
Keywords: Bloodstream infections; Carbapenem resistance; Klebsiella pneumoniae; Mortality; Risk factors.
Copyright © 2019 Nanjing Medical University. Published by Elsevier Ltd.. All rights reserved.