| AimKlebsiella pneumonia(KP)is a common clinical pathogen that can cause multiple infections.KP bloodstream infection is the main type of bacterial bloodstream infection(BSI).At present,the mortality of bloodstream infection caused by KP is high,which brings economic burden to society.The purpose of this study is to support early prevention,early treatment and to provide guiding significance for clinical treatment according to explore the risk factor and outcomes of bloodstream infection due to KP.MethodRetrospectively collected clinical data of patients with KP infection in the KP strain library of Fujian Provincial Hospital from 2017.06.01 to 2019.06.01.The inclusion criteria for the experimental group of bloodstream infected KP;1)Meet the diagnostic criteria for bloodstream infection by the Chinese Family Planning Commission(2001 edition);2)≥ 18 years old;3)≥ 1 peripheral venous blood and(or)end-catheter culture KP positive;4)complete case data;5)If there are multiple duplicate specimens of the same patient,the first specimen will be taken into this experimental group.The inclusion criteria for the control group of non-bloodstream infected KP group: 1)≥18years old;2)complete case information;3)The KP detected at the infected site is clearly a pathogen,not a colonizing bacteria.4)If there are multiple duplicate specimens of the same patient,the first specimen will be taken into this group.Exclusion criteria: 1)﹤ 18 years old;2)Incomplete case data;3)other pathogenic microorganisms were cultured in blood and(or)end-catheter.4)KP was cultured in the specimen(not in blood),which was considered as colonizing bacteria.Lastly,univariate and multivariate logistic analyses were performed to explore the risk factor and outcomes of bloodstream infection due to KP by SPSS 22.0 software.Result1 A total of 449 KP strains meeting the standard were collected from the KP strain library of Fujian Provincial Hospital,of which 114 cases is bloodstream infected KP and 335 cases is non-bloodstream infected KP.There were no statistically significant differences in age,gender and the number of CRKP between the KP bloodstream infected group and the KP non-bloodstream infected group.The mortality due to KP bloodstream infected group occurred in 25.43 %(29/114).And there were significant statistical significance about infectious shock,MODS and mortality(P value < 0.05)between them.2 The main type of bloodstream infections KP in our hospital was primary bloodstream infections(63.16%,72/114),catheter related blood stream infection was rare(2.54%,3/114).The main detection departments of bloodstream infections caused by KP in our hospital were intensive care unit(28.95%,33/114),hepatobiliary surgery(14.91,17/114),and gastroenterology(14.04%,16/114).Then,the detection rate of bloodstream infection caused by CRKP was 20.18%(23/114).In our study,the main empirical treatment options are third-generation cephalosporins,quinolone antibiotics,and carbapenem antibiotics,tigecycline and carbapenem antibiotics are their main anti-infective drugs according to the results of Drug Susceptibility Test.3 In our study,with malignant tumors(OR value 12.15,P value <0.01),deep vein catheterization(OR value 2.15,P value = 0.023),and multiple infections(P value<0.01)and liver abscess(OR value 7.76,P value <0.001)were independent risk factors for bloodstream infection due to KP in our hospital.4 Long hospital stay(>90 days)(OR value 672.27,P value = 0.007),treatment with tigecycline(OR value 68.20,P value = 0.027),high Apache II score(OR value 1.58,P value = 0.04)were the independent risk factor of mortality in bloodstream infected KP.ConclusionKP BSI has a high mortality rate and is easy to be complicated with organ dysfunction.Critically illness and the use of tigecycline anti-infective therapy were the main risk factors of mortality in bloodstream infection due to KP.We should evaluate the patient’s basic situation and condition in a timely manner,and rationally use antibacterial drugs. |
PDF Full Text Request