Risk factors and mortality for patients with Bloodstream infections of Klebsiella pneumoniae during 2014–2018: Clinical impact of carbapenem resistance in a large tertiary hospital of China
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...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-05-01
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| Series: | Journal of Infection and Public Health |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1876034119303557 |
| _version_ | 1818274951214399488 |
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| author | Haiyan Chang Jie Wei Wanqing Zhou Xiaomin Yan Xiaoli Cao Lingyun Zuo Shixing Chen Kefang Yao Rui Huang Yuxin Chen Chao Wu |
| author_facet | Haiyan Chang Jie Wei Wanqing Zhou Xiaomin Yan Xiaoli Cao Lingyun Zuo Shixing Chen Kefang Yao Rui Huang Yuxin Chen Chao Wu |
| author_sort | Haiyan Chang |
| collection | DOAJ |
| description | 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, Risk factors, Mortality |
| first_indexed | 2024-12-12T22:22:01Z |
| format | Article |
| id | doaj.art-3d443fada3dc42dfa44df0336f6399e9 |
| institution | Directory Open Access Journal |
| issn | 1876-0341 |
| language | English |
| last_indexed | 2024-12-12T22:22:01Z |
| publishDate | 2020-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Infection and Public Health |
| spelling | doaj.art-3d443fada3dc42dfa44df0336f6399e92022-12-22T00:09:53ZengElsevierJournal of Infection and Public Health1876-03412020-05-01135784790Risk factors and mortality for patients with Bloodstream infections of Klebsiella pneumoniae during 2014–2018: Clinical impact of carbapenem resistance in a large tertiary hospital of ChinaHaiyan Chang0Jie Wei1Wanqing Zhou2Xiaomin Yan3Xiaoli Cao4Lingyun Zuo5Shixing Chen6Kefang Yao7Rui Huang8Yuxin Chen9Chao Wu10Department of Infectious Diseases, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu, 210008, ChinaDepartment of Infectious Diseases, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu, 210008, ChinaDepartment of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, 210008, ChinaDepartment of Infectious Diseases, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu, 210008, ChinaDepartment of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, 210008, ChinaDepartment of Infectious Diseases, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu, 210008, ChinaDepartment of Infectious Diseases, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu, 210008, ChinaDepartment of Infectious Diseases, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu, 210008, ChinaDepartment of Infectious Diseases, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu, 210008, ChinaDepartment of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, 210008, China; Corresponding authors.Department of Infectious Diseases, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu, 210008, China; Corresponding authors.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, Risk factors, Mortalityhttp://www.sciencedirect.com/science/article/pii/S1876034119303557 |
| spellingShingle | Haiyan Chang Jie Wei Wanqing Zhou Xiaomin Yan Xiaoli Cao Lingyun Zuo Shixing Chen Kefang Yao Rui Huang Yuxin Chen Chao Wu Risk factors and mortality for patients with Bloodstream infections of Klebsiella pneumoniae during 2014–2018: Clinical impact of carbapenem resistance in a large tertiary hospital of China Journal of Infection and Public Health |
| title | Risk factors and mortality for patients with Bloodstream infections of Klebsiella pneumoniae during 2014–2018: Clinical impact of carbapenem resistance in a large tertiary hospital of China |
| title_full | Risk factors and mortality for patients with Bloodstream infections of Klebsiella pneumoniae during 2014–2018: Clinical impact of carbapenem resistance in a large tertiary hospital of China |
| title_fullStr | Risk factors and mortality for patients with Bloodstream infections of Klebsiella pneumoniae during 2014–2018: Clinical impact of carbapenem resistance in a large tertiary hospital of China |
| title_full_unstemmed | Risk factors and mortality for patients with Bloodstream infections of Klebsiella pneumoniae during 2014–2018: Clinical impact of carbapenem resistance in a large tertiary hospital of China |
| title_short | Risk factors and mortality for patients with Bloodstream infections of Klebsiella pneumoniae during 2014–2018: Clinical impact of carbapenem resistance in a large tertiary hospital of China |
| title_sort | risk factors and mortality for patients with bloodstream infections of klebsiella pneumoniae during 2014 2018 clinical impact of carbapenem resistance in a large tertiary hospital of china |
| url | http://www.sciencedirect.com/science/article/pii/S1876034119303557 |
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