Objective: To explore the risk factors for infection of carbapenem-resistant Klebsiella pneumoniae(CRKP)in gerontal patients in our hospital and establish the corresponding prediction model.Methods: Through the retrospective collection of case data of gerontal patients infected with CRKP who were treated in our hospital from January 2020 to September2021,a total of 552 gerontal patients infected with Klebsiella pneumoniae were finally included in this research after screening these subjects according to the inclusion and exclusion criteria.Meanwhile,a series of information including general information(such as age,gender,department distribution,and specimen source),use of antibacterial drugs,invasive operations,concomitant diseases,hospitalization duration,and hospitalization in the intensive care unit(ICU)of the patients were collected in this research.Subjects were further divided into a resistance group(n=73)and a sensitivity group(n=479)according to the presence or absence of resistance to carbapenems.On this basis,in this study,the univariate analysis was firstly performed on the risk factors affecting the infection of CRKP in gerontal patients,and the corresponding prediction model was constructed by the logistic regression analysis.In closing,the receiver operation characteristic(ROC)curve was plotted for further evaluation.Results:1.This research included 552 gerontal patients infected with Klebsiella pneumoniae,of which 396 were males and 156 were females.Among them,a total of 73 subjects were included in the CRKP group,with a detection rate of 13.22%(73/552).There were no statistically significant sex comparisons(χ2=1.487,P= 0.223)between subjects in the CRKP group and those in the carbapenem-sensitive Klebsiella pneumoniae(CSKP)group.2.Among the 552 eligible specimens included in this research,the top three departments in terms of the source of Klebsiella pneumoniae infection specimens were Neurosurgery(14.86%,82/552),ICU(14.31%,79/552),and Neurology(12.32%,68/552).On the other hand,the top three departments in terms of the source of CRKP infection specimens were ICU(42.47%,31/73),Neurosurgery(12.33%,9/73),and Emergency Department(12.33%,9/73).3.Among the 552 eligible specimens included in this research,the first three sources of Klebsiella pneumoniae infection were sputum(81.34%,449/552),urine(8.51%,47/552),and blood(4.35%,24/552).Likewise,the first three sources of CRKP infection were sputum(83.56%,61/73),urine(6.85%,5/73),and blood(4.11%,3/73).4.According to the results of univariate analysis,a total of 25 factors,encompassing the use of carbapenems,quinolones,beta-lactams/beta-lactamase inhibitors,glycopeptides,aminoglycosides,use of urinary catheters,nasogastric tubes,central venous catheters(CVC),arterial canals,tracheotomy,tracheal intubation,sputum aspiration,blood transfusion,bronchoscopy,paracentesis(specifically thoracentesis,abdominal paracentesis,lumbar puncture,bone marrow puncture),blood purification,ICU admission,ICU inpatient time greater than or equal to 7 days,inpatient time greater than or equal to 14 days,the use of greater than or equal to 2 kinds of antibiotics,antibiotic use time greater than or equal to 7 days,digestive diseases,respiratory diseases,blood diseases,liver diseases,constituted the risk factors for CRKP infection in gerontal patients(P < 0.05).5.Through multivariate logistic regression analysis,it was found that six factors,encompassing antibiotic use time greater than or equal to 7 days(P=0.013),admission to the ICU(P=0.003),ICU admission time greater than or equal to 7 days(P= 0.041),digestive disease(P=0.023),blood purification(P=0.020),and use of quinolones(P<0.001),were independent risk factors for CRKP infection(all P<0.05).6.By plotting the ROC curve,it is indicated that the area under curve(AUC)was 0.846(P < 0.05);the Youden index was 0.610;the sensitivity was 0.740;and,the specificity was 0.871.Conclusion: To sum up,six factors,encompassing antibiotic use time greater than or equal to 7 days,admission to the ICU,ICU admission time greater than or equal to 7days,digestive disease,blood purification,and use of quinolones,were independent risk factors for CRKP infection in gerontal patients.The CRKP infection prediction model for gerontal patients based on the above indicators has a good prediction value.In terms of assessing the risk of CRKP infection in gerontal patients,developing reasonable infection prevention and control measures has great guiding significance. |