Clinical Characteristics And Risk Factors Of XDR-klebsiella Pneumoniae LRTI In RICU

Objective:To analyze the clinical characteristics and risk factors of XDR-Klebsiella pneumoniae lower respiratory tract infection(LRTI)in RICU.Methods:A retrospective analysis was made to the clinical material of 21 patients with LRTI caused by XDR-Klebsiella pneumoniae admitted to RICU during 2016.06~2017.02,31 patients with LRTI caused by MDR-Klebsiella pneumoniae as the control group.Clinical characteristics(age,sex,underlying diseases,etc.),risk factors,treatment and prognosis was studied.Results:1.The average age of 21 patients with XDR-Kpn LRTI was 75.38±11.61 years old.The average age of the control group(31 cases of MDR-KPn LRTI)was 69.79±14.61 years old.2.The incidence of XDR-Kpn LRTI patients was mainly in two peaks of 2016.12~2017.01.3.The majority of the two groups of patients had underlying diseases,and some patients had more than two underlying diseases.4.Univariate analysis showed that the time stayed in RICU(? 7 days),the application of broad-spectrum antibiotics for more than 7 days before Kpn was isolated,high APACHEII score(?20)and the conducted of tracheal intubation or incision for more than 7 days were risk factors of XDR-Kpn LRTI in RICU.5.The rate of deterioration(death and automatic discharge ratio)of the XDR-Kpn induced LRTI patients in our RICU was up 95.2%.The treatment of XDR-Kpn LRTI was mainly carbapenems and tigecycline,and the effect on these patients was poor.Conclusion:1.The XDRKpn LRTI patients in RICU were generally older and there were more males than females.They had more basic diseases and poor prognosis.2.Stay in the RICU time(?7 days),the application of broad-spectrum antibiotics before the separation of Kpn?7 days,high APACHEII score(?20)and Tracheal intubation or incision?7 days are common susceptibility factors of patients with XDRKpn nosocomial infection.3.The use of carbapenems and tigecycline as a combination of anti-infective regimens for the treatment of XDRKpn's LRTI was poor.