Risk Factor Analysis of Carbapenem-Resistant Klebsiella Pneumoniae Infection and Mortality in Respiratory Intensive Care Unit Patients

WANG Zhongjie; QUE Mi; YUAN Zhe; QIAN Keli

doi:10.3969/j.issn.2096-3351.2024.02.010

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Risk Factor Analysis of Carbapenem-Resistant Klebsiella Pneumoniae Infection and Mortality in Respiratory Intensive Care Unit Patients

更新时间：2024-04-11

- Risk Factor Analysis of Carbapenem-Resistant Klebsiella Pneumoniae Infection and Mortality in Respiratory Intensive Care Unit Patients
- Journal of Southwest Medical University Vol. 47, Issue 2, Pages: 147-151(2024)
- 作者机构：
  
  1. 重庆医科大学附属第一医院医院感染管理科,重庆,400016
  2. 重庆医科大学附属第一医院感染科·重庆市传染病寄生虫病学重点实验室,重庆,400016
- 作者简介：
- 基金信息：
- DOI：10.3969/j.issn.2096-3351.2024.02.010
  CLC：
- Published：2024，
  
  Published Online：20 March 2024，
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WANG Zhongjie, QUE Mi, YUAN Zhe, et al. Risk Factor Analysis of Carbapenem-Resistant Klebsiella Pneumoniae Infection and Mortality in Respiratory Intensive Care Unit Patients. [J]. Journal of Southwest Medical University 47(2):147-151(2024)
DOI：

WANG Zhongjie, QUE Mi, YUAN Zhe, et al. Risk Factor Analysis of Carbapenem-Resistant Klebsiella Pneumoniae Infection and Mortality in Respiratory Intensive Care Unit Patients. [J]. Journal of Southwest Medical University 47(2):147-151(2024) DOI： 10.3969/j.issn.2096-3351.2024.02.010.

摘要

目的探究呼吸重症监护室患者感染耐碳青霉烯类肺炎克雷伯菌（carbapenem-resistant klebsiella pneumoniae，CRKP）的感染和死亡危险因素。方法选择某三甲医院2021 年10 月至2022 年4 月呼吸重症监护室住院患者93 例，分为CRKP 组43 例和对照组50 例，根据出院情况将CRKP 组分为生存组12 例和死亡组31 例进一步分析。将对照研究中有意义的因素纳入Logistic 回归模型进行多因素分析，探究CRKP 感染危险因素和死亡危险因素。结果性别、慢性肾脏疾病、中心静脉置管时间、机械通气时间、留置导尿管时间、谷丙转氨酶（alaninetransaminase，ALT）、白介素-6（interleukin-6，IL-6）和C 反应蛋白（c-reactive protein，CRP）均与CRKP 感染相关（P < 0.05）；CRP、IL-6 和脓毒血症与CRKP 感染后死亡相关（P < 0.05）。多因素分析结果显示，机械通气时间、ALT 是CRKP 感染的独立危险因素；脓毒血症是CRKP 感染后死亡的独立危险因素。结论CRKP 感染患者死亡率较高；正确识别CRKP 感染的独立危险因素，有助于CRKP 的管理，进而降低患者死亡率。

Abstract

Objective To investigate the Risk Factors for Infection and Mortality Associated with Carbapenem-Resistant Klebsi⁃ ella Pneumoniae（CRKP）in Patients in the Respiratory Intensive Care Unit. Methods A total of 93 hospitalized patients in the respiratory ICU of a tertiary hospital from October 2021 to April 2022 were selected. They were divided into CRKP group（43 patients）and control group（50 patients）. The CRKP group was further stratified into survival subgroup（12 patients）and mortality subgroup（31 patients） for further analysis. Factors of significance in the control study were included in a Logistic regression model for multifactorial analysis to explore the risk factors for CRKP infection and mortality. Results The results indicated that gender，chronic kidney disease， duration of central venous catheter placement，mechanical ventilation time，indwelling urinary catheter time，Alanine transaminase （ALT），Interleukin-6（IL-6），and C-reactive protein（CRP）were all associated with CRKP infection（P < 0.05）；CRP，IL-6，and sepsis were correlated with mortality following CRKP infection（P < 0.05）. Multivariate analysis revealed that mechanical ventilation time and ALT were independent risk factors for CRKP infection；sepsis was an independent risk factor for mortality post CRKP infection. Conclusion The mortality rate in patients with CRKP infection was high. Correctly identifying the independent risk factors for CRKP infection could aid in the management of CRKP and reduce patient mortality.

关键词

耐碳青霉烯肺炎克雷伯菌危险因素呼吸重症监护室危险因素

Keywords

Carbapenem-resistant Klebsiella pneumoniaeRisk factorsRespiratory intensive care unitRisk factor

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