Risk Factors and Prognosis of Carbapenem-Resistant Klebsiella pneumoniae Infections in Respiratory Intensive Care Unit: A Retrospective Study

Huan Zhang,1,2 Jin Wang,1 Weiying Zhou,2 Ming Yang,3 Rui Wang,1 Xin Yan,4 Yun Cai1 1Centre of Medicine Clinical Research, Department of Pharmacy, Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China; 2College of Pharmacy, Chongqing Medical University, Chongqing, 400016, People’s...

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Main Authors: Zhang H, Wang J, Zhou W, Yang M, Wang R, Yan X, Cai Y
Format: Article
Language:English
Published: Dove Medical Press 2021-08-01
Series:Infection and Drug Resistance
Subjects:
Online Access:https://www.dovepress.com/risk-factors-and-prognosis-of-carbapenem-resistant-klebsiella-pneumoni-peer-reviewed-fulltext-article-IDR
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author Zhang H
Wang J
Zhou W
Yang M
Wang R
Yan X
Cai Y
author_facet Zhang H
Wang J
Zhou W
Yang M
Wang R
Yan X
Cai Y
author_sort Zhang H
collection DOAJ
description Huan Zhang,1,2 Jin Wang,1 Weiying Zhou,2 Ming Yang,3 Rui Wang,1 Xin Yan,4 Yun Cai1 1Centre of Medicine Clinical Research, Department of Pharmacy, Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China; 2College of Pharmacy, Chongqing Medical University, Chongqing, 400016, People’s Republic of China; 3Centre of Big Data, Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China; 4College of Laboratory Medicine, Chongqing Medical University, Chongqing, 400016, People’s Republic of ChinaCorrespondence: Yun Cai 28 Fu Xing Road, Beijing, 100853, People’s Republic of ChinaTel +86-10-6693-7166Fax +86-10-8821-4425Email caicai_hh@126.comPurpose: Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections have become a serious threat with high morbidity and mortality. Early identification of risk factors for CRKP infections is important, but these factors are still controversial. Therefore, we aimed to identify the risk factors and clinical outcomes of CRKP infections.Patients and Methods: The retrospective, single-center study was carried out in the respiratory intensive care unit of the Chinese People’s Liberation Army General Hospital from 2017 to 2020. Patients infected with K. pneumoniae were included and categorized into the CRKP group and carbapenem-sensitive K. pneumoniae (CSKP) group based on the susceptibility to carbapenems. The independent risk factors were investigated by univariate analysis and multivariate logistic regression analysis. The clinical outcomes were also evaluated between the two groups.Results: A total of 138 eligible patients were included in our study, with a median age of 80.5 years (interquartile range: 62.0– 86.3), and 78.3% of them were males. Of the 138 patients, there were 97 patients in the CRKP group, and the other 41 were assigned into the CSKP group. Multivariate analysis showed that exposure to ≥three types of comorbidities (OR = 5.465, P = 0.003), previous hospitalization (OR = 4.279, P = 0.006), use of quinolones (OR = 5.872, P = 0.012), and indwelling urinary catheter (OR = 5.035, P = 0.000) were independent risk factors for CRKP infections. The in-hospital mortality rate of the CRKP group was 42.1%, which was higher compared with the CSKP group (17.5%, P = 0.006).Conclusion: Exposure to ≥three types of comorbidities, previous hospitalization, use of quinolones, and indwelling urinary catheter were independent risk factors for CRKP infections, which had higher mortality compared with CSKP infections. Early detection of high-risk patients and timely control measures should be implemented to prevent the emergence of CRKP infections and thereby improve the clinical outcomes.Keywords: carbapenems, Klebsiella pneumoniae, resistance, risk factors, prognosis
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spelling doaj.art-d0d1ad9465c84ebeb920d7f2427a1e902022-12-21T18:50:13ZengDove Medical PressInfection and Drug Resistance1178-69732021-08-01Volume 143297330568016Risk Factors and Prognosis of Carbapenem-Resistant Klebsiella pneumoniae Infections in Respiratory Intensive Care Unit: A Retrospective StudyZhang HWang JZhou WYang MWang RYan XCai YHuan Zhang,1,2 Jin Wang,1 Weiying Zhou,2 Ming Yang,3 Rui Wang,1 Xin Yan,4 Yun Cai1 1Centre of Medicine Clinical Research, Department of Pharmacy, Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China; 2College of Pharmacy, Chongqing Medical University, Chongqing, 400016, People’s Republic of China; 3Centre of Big Data, Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China; 4College of Laboratory Medicine, Chongqing Medical University, Chongqing, 400016, People’s Republic of ChinaCorrespondence: Yun Cai 28 Fu Xing Road, Beijing, 100853, People’s Republic of ChinaTel +86-10-6693-7166Fax +86-10-8821-4425Email caicai_hh@126.comPurpose: Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections have become a serious threat with high morbidity and mortality. Early identification of risk factors for CRKP infections is important, but these factors are still controversial. Therefore, we aimed to identify the risk factors and clinical outcomes of CRKP infections.Patients and Methods: The retrospective, single-center study was carried out in the respiratory intensive care unit of the Chinese People’s Liberation Army General Hospital from 2017 to 2020. Patients infected with K. pneumoniae were included and categorized into the CRKP group and carbapenem-sensitive K. pneumoniae (CSKP) group based on the susceptibility to carbapenems. The independent risk factors were investigated by univariate analysis and multivariate logistic regression analysis. The clinical outcomes were also evaluated between the two groups.Results: A total of 138 eligible patients were included in our study, with a median age of 80.5 years (interquartile range: 62.0– 86.3), and 78.3% of them were males. Of the 138 patients, there were 97 patients in the CRKP group, and the other 41 were assigned into the CSKP group. Multivariate analysis showed that exposure to ≥three types of comorbidities (OR = 5.465, P = 0.003), previous hospitalization (OR = 4.279, P = 0.006), use of quinolones (OR = 5.872, P = 0.012), and indwelling urinary catheter (OR = 5.035, P = 0.000) were independent risk factors for CRKP infections. The in-hospital mortality rate of the CRKP group was 42.1%, which was higher compared with the CSKP group (17.5%, P = 0.006).Conclusion: Exposure to ≥three types of comorbidities, previous hospitalization, use of quinolones, and indwelling urinary catheter were independent risk factors for CRKP infections, which had higher mortality compared with CSKP infections. Early detection of high-risk patients and timely control measures should be implemented to prevent the emergence of CRKP infections and thereby improve the clinical outcomes.Keywords: carbapenems, Klebsiella pneumoniae, resistance, risk factors, prognosishttps://www.dovepress.com/risk-factors-and-prognosis-of-carbapenem-resistant-klebsiella-pneumoni-peer-reviewed-fulltext-article-IDRcarbapenemsklebsiella pneumoniaeresistancerisk factorsprognosis
spellingShingle Zhang H
Wang J
Zhou W
Yang M
Wang R
Yan X
Cai Y
Risk Factors and Prognosis of Carbapenem-Resistant Klebsiella pneumoniae Infections in Respiratory Intensive Care Unit: A Retrospective Study
Infection and Drug Resistance
carbapenems
klebsiella pneumoniae
resistance
risk factors
prognosis
title Risk Factors and Prognosis of Carbapenem-Resistant Klebsiella pneumoniae Infections in Respiratory Intensive Care Unit: A Retrospective Study
title_full Risk Factors and Prognosis of Carbapenem-Resistant Klebsiella pneumoniae Infections in Respiratory Intensive Care Unit: A Retrospective Study
title_fullStr Risk Factors and Prognosis of Carbapenem-Resistant Klebsiella pneumoniae Infections in Respiratory Intensive Care Unit: A Retrospective Study
title_full_unstemmed Risk Factors and Prognosis of Carbapenem-Resistant Klebsiella pneumoniae Infections in Respiratory Intensive Care Unit: A Retrospective Study
title_short Risk Factors and Prognosis of Carbapenem-Resistant Klebsiella pneumoniae Infections in Respiratory Intensive Care Unit: A Retrospective Study
title_sort risk factors and prognosis of carbapenem resistant klebsiella pneumoniae infections in respiratory intensive care unit a retrospective study
topic carbapenems
klebsiella pneumoniae
resistance
risk factors
prognosis
url https://www.dovepress.com/risk-factors-and-prognosis-of-carbapenem-resistant-klebsiella-pneumoni-peer-reviewed-fulltext-article-IDR
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