Risk Factors For Hypervirulent Klebsiella Pneumoniae Infection:A Meta-Analysis

Objective: Hypervirulent Klebsiella pneumoniae(Hv KP)infection is a community acquired infection with high mortality and high disability in China.However,studies on the corresponding risk factors of Hv KP infection showed inconsistent results.To resolve these inconsistencies,we conducted a meta-analysis of previous studies on the risk factors of Hv KP infection.The results of this study could be used to prevent and diagnose Hv KP infection early.Methods: Searching Pub Med,Embase and Cochrane library foreign databases,CNKI,Wan Fang,VIP Chinese database through the internet,we searched the article published in domestic and foreign journals and related risk factors of Hv KP infection from the establishment of these databases to January 2020.According to the selection and exclusion criteria,we screened qualified literatures,and evaluated the quality of article.The clinical data were meta-analyzed by stata 15.1 software,with odds ratio(OR)and 95% confidence interval(CI)as effect value indicators.Results: According to the selection and exclusion criteria of the literature,9 articles related to risk factors of Hv KP infection were finally included,including 1 in Chinese and 8 in English.All of these studies were retrospective studies.The total number of subjects was 1445,504 in Hv KP patients and 941 in non-Hv KP patients.The metaanalysis' s results showed that the incidence of diabetes mellitus(OR/MD=3.00,95%CI: 2.08~4.35),community-acquired infections(OR/MD=5.92,95%CI: 2.26~15.46),abscess(OR/MD= 5.92,95%CI: 2.26~15.46)are closely related to the Hv KP infections,while antimicrobial use(OR/MD= 1.22,95%CI: 0.25~5.94)and cancer(OR/MD= 1.61,95%CI: 0.37~7.02)had no statistical difference with Hv KP infections.Conclusion:Diabetes,community-acquired infections and abscesses are the main risk factors for Hv KP infections.We have found that exposure in Asian or Asian regions may also be a risk factor for Hv KP infection,so controlling blood sugar level and reducing exposure in Hv KP high-prevalence area may reduce Hv KP infection.Communityacquired infections such as liver abscess should be considered as Hv KP infection.Identification of risk factors could play an important role in the prevention and early diagnosis of Hv KP infection.