Therapeutic Effect And Prognosis Factors For The Infection Of Carbapenem-resistant Klebsieila Pneumonia In Patients

Objective:To investigate the clinical efficacy in the patients infected by Carbapenem-resistant Klebsiella Pneumonia in our hospital, and analyze the influencing factor to the clinical efficacy, and to provide the valuable references for the clinical treatment.Methods:A total of91patients with nosocomial infection, in which Carbapenem-resistant Klebsiella Pneumonia was separated and cultivated, were included in the different endemic area in our hospital in Dec,2011-Nov,2013. The general clinical data of each case were collected, and the anti-infective therapy effect of each case was followed up. The influencing factors to the clinical efficacy were analyzed by single-factor analysis and multivariate logistic regression analysis.Results:1. There are26cases (28.57%) with cured effect,38cases (41.76%) with improved effect, and27cases (29.67%) with null effect.2. We had analysis the factors include the gender, age, admission ward, complications, hospitalization with in90days of admission history,hospitalization in90days before CRKP virus isolation and culture positive,duration in the ICU before pathogen isolation and culture positive,the type of infection,APACHE Ⅱ (acute physiology and chronic health evaluation Ⅱ, APACHE Ⅱ score),duration of mechanical ventilation, special treatment, catheters, fistula, multidrug resistance strains in vitro, strains in vitro of carbapenem resistantsituation, combined with other bacterial infections,combined with fungal infection, first treatment after pathogen isolation and culture positive.The results of single-factor analysis shows that hospitalization in90days before CRKP virus isolation and culture positive,the type of infection,duration of mechanical ventilation,,combined with fungal infection, first treatment after pathogen isolation and culture positive had the effect on the Overall efficiency (P<0.05or P<0.01), the others have no effect on the Overall efficiency(P>0.05);and hospitalization in90days before CRKP virus isolation and culture positive,the type of infection,duration of mechanical ventilation and combined with other bacterial infections had the effect on the cure rate(P<0.05or P<0.01), the others have no effect on the cure rate(P>0.05).3.Multivariate logistic regression analysis results show that all factors had no effect on the Overall efficiency(P>0.05),hospitalization in90days before CRKP virus isolation and culture positive,duration of mechanical ventilation had the effect on the cure rate(P<0.05or P<0.01).Conclusions:1.The clinical efficacy in the patients infected by Carbapenem-resistant Klebsiella Pneumonia was poor.2.It is better to improve the clinical efficacy in the patients infected by Carbapenem-resistant Klebsiella Pneumonia to use antibacterial drugs strictly in clinic and reduce the appearance of Carbapenem-resistant Klebsiella Pneumonia.3. The hospital stay history, hospital stay with positive etiology and the antibiotic resistance condition had the effect on the clinical efficacy, which should be considered when the antibacterial treatment progress is decided.