Analysis of Risk Factors and Mortality of Patients with Carbapenem-Resistant Klebsiella pneumoniae Infection

Abstract

Background

Carbapenem-resistant Klebsiella pneumoniae (CRKP) infection is associated with high mortality and has become a major public problem threatening patients. This study aimed to explore risk factors for death in patients with Klebsiella pneumoniae (KP) and identify risk factors for CRKP infection.

Methods

The study retrospectively analyzed clinical characteristics and microbiological data from patients infected with KP from January 2019 to October 2021 to identify risk factors and mortality, using multivariate logistic regression analysis and Cox regression analysis.

Results

A total of 214 KP inpatients were enrolled in our study. The in-hospital mortality rate was significantly higher in patients infected with CRKP (13/68, 19.12%) than carbapenem-susceptible KP (CSKP) (2/146, 1.37%) and the difference was statistically significant (P= 0.03). Multivariate Cox regression analysis showed CRKP isolation (HR 12.26, 95% CI 2.43–61.68, P = 0.002), lower TP (HR 10.50, 95% CI 1.33–82.76, P = 0.03), antibiotic days of therapy >15 (HR 0.08, 95% CI 0.01–0.56, P= 0.01) and length of stay (LOS) (HR 0.03, 95% CI 0.002–0.61, P= 0.02) were independent risk factors for death from KP. Additionally, intensive care unit (ICU) stay (OR 21.69, 95% CI 4.50–118.76, P< 0.001) and previous carbapenem exposure (OR 5.26, 95% CI 1.38–21.19, P= 0.02) are independent risk factors for CRKP.

Conclusion

Our findings showed that patients infected with CRKP have a higher in-hospital mortality rate. Identifying the independent risk factors for CRKP infection may contribute to the management of CRKP and reduce the mortality of KP patients.

Keywords:

• carbapenem-resistant
• Klebsiella pneumoniae
• risk factors
• mortality

Abbreviations

ICU, intensive care unit; KP, Klebsiella pneumoniae; CRKP, Carbapenem-resistant Klebsiella pneumoniae, CSKP, carbapenem-susceptible Klebsiella pneumoniae; LOS, length of stay.

Data Sharing Statement

For reasons of medical research ethics and confidentiality, trial data are not publicly available. However, in addition to personal private information, other research data may also be obtained from corresponding authors upon reasonable request by the Ethics Committee.

Ethics Approval and Consent to Participate

The Study involving human participants received ethical approval from the Institutional Review Board (IRB) of Shunde Hospital, Southern Medical University. The IRB approval number is 2020071. For all patients, the purpose of the study was clearly explained, and written informed consent was obtained prior to admission, stating that medical records (medical records, laboratory tests, etc.) would be kept completely on the hospital’s medical record system during hospitalization. Researchers, ethics committees, and drug regulators will be allowed access to medical records. This study was conducted in accordance with the Declaration of Helsinki.

Acknowledgment

The authors would like to thank those who participated in this study.

Disclosure

The authors have no conflict of interest in this work.