Clinical and Epidemiological Characteristics of Carbapenem-Resistant Klebsiella pneumoniae Infections in a Tertiary Hospital in China

Microb Drug Resist. 2023 Sep;29(9):401-406. doi: 10.1089/mdr.2022.0280. Epub 2023 May 15.

Abstract

Purpose: Infections caused by carbapenem-resistant Klebsiella pneumoniae (CR-KP) are an important public health problem. This study aimed to evaluate the clinical characteristics of patients with CR-KP. Methods: A retrospective cohort study was conducted of all patients with CR-KP infection. A total of 615 patients with CR-KP infection were identified and 135 patients who did not meet the eligibility criteria were excluded. Clinical characteristics, antimicrobial regimens, and patient outcomes were analyzed. Results: The overall mortality rate of CR-KP infections was 37.3% and the mortality rate in patients with bloodstream infections was 66.2%. Survival analysis revealed that there were statistically significant differences between patients with bloodstream infections and those with pulmonary and drainage fluid infections. Logistics regression analysis showed that hemopathy, age >60 years, solid tumors, diabetes, septic shock, acute kidney injury, and stroke were independent predictors of 30-day mortality rate. The chi-square test showed that treatment with a combination of carbapenems, tigecycline, and polymyxin B was superior to treatment with carbapenems with polymyxin B, without tigecycline. Conclusions: CR-KP infections, especially bloodstream infections, have a high mortality rate. The outcome is strongly dependent on patients' clinical conditions. Antimicrobial regimens combining carbapenems, tigecycline, and polymyxin B might be a better choice.

Keywords: antimicrobial regimen; bloodstream infection; carbapenem-resistant Klebsiella pneumoniae; clinical characteristics.

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Carbapenem-Resistant Enterobacteriaceae*
  • Carbapenems / pharmacology
  • Carbapenems / therapeutic use
  • China / epidemiology
  • Humans
  • Klebsiella pneumoniae
  • Microbial Sensitivity Tests
  • Middle Aged
  • Polymyxin B
  • Retrospective Studies
  • Sepsis*
  • Tertiary Care Centers
  • Tigecycline

Substances

  • Polymyxin B
  • Tigecycline
  • Anti-Bacterial Agents
  • Carbapenems