Clinical characteristics and prognostic factors of 108 cases of Klebsiella pneumoniae bloodstream infection

Abstract:

Objective To explore the clinical characteristics of Klebsiella pneumoniae bloodstream infection in Yongchuan Hospital of Chongqing Medical University and the risk factors affecting the prognosis.Methods The clinical and laboratory data of 108 patients with Klebsiella pneumoniae bloodstream infection who were admitted to hospital from January 2019 to July 2021 were retrospectively analyzed. The patients were divided into clinical improvement group and poor prognosis group according to clinical outcomes. Logistic regression and receiver operator characteristic(ROC) curve were used to analyze the predictors of poor outcome.Results Patients with Klebsiella pneumoniae bloodstream infection were mainly distributed in ICU（19.4%），department of infectious diseases（13.9%），department of hepatobiliary surgery（10.3%），department of hematology（8.4%） and so on； 86.1% patients suffered from underlying diseases，including diabetes mellitus（38.9%），hypertension（25.0%），and malignant solid tumor（14.8%）. The resistance rates of 108 strains of bloodstream infection-caused Klebsiella pneumoniae and 1 631 strains of non-bloodstream infection-caused Klebsiella pneumoniae were 8.3% and 14.8%，respectively. There were significant differences in age，hospital stay，ICU admission and anemia between poor prognosis group and clinical improvement group（P < 0.05）. The multivariate logistic regression analysis showed that age（OR=1.044，95%CI=0.002-0.083，P=0.038），length of hospital stay（OR=0.936，95%CI=-0.110--0.023，P=0.003），admission to ICU（OR=8.794，95%CI=0.855-3.493，P=0.001），and anemia（OR=5.638，95%CI=0.684-2.775，P=0.001）were independent risk factors for the poor prognosis of Klebsiella pneumoniae bloodstream infection. Furthermore，elevated PCT（OR=0.094，95%CI=0.021-0.166，P=0.011）was shown to be a risk factor for death from Klebsiella pneumoniae bloodstream infection.Conclusion The elderly，anemia and ICU stay are risk factors for poor prognosis in patients with Klebsiella pneumoniae bloodstream infection. Early etiological examination and appropriate empirical treatment can improve the prognosis.