A retrospective, comparative analysis of risk factors and outcomes in carbapenem-susceptible and carbapenem-nonsusceptible Klebsiella pneumoniae bloodstream infections: tigecycline significantly increases the mortality.

摘要: Background Carbapenem-nonsusceptible Klebsiella pneumoniae (CnSKP) is rapidly emerging as a life-threatening nosocomial infection. The efficacy of tigecycline in the treatment bloodstream infections (BSIs) remains controversial. Methods Data from total 428 patients with carbapenem-susceptible (CSKP) and CnSKP BSIs were collected at single center between January 2013 December 2015. A three-part analysis was conducted to identify risk factors associated CnSKP, explore prognosis, evaluate treatments. Results (KP) included, 31.5% (n=135) them CnSKP. Multivariate showed that prior hospitalization, urinary catheterization, use immunosuppressive agents, antibiotics, pulmonary disease, high Acute Physiology Chronic Health Evaluation (APACHE) II scores independent for CnSKP-BSIs. 30-day mortality higher than those CSKP (58.5% vs 15.4%; P<0.001). In KP-BSIs, neutropenia, multiple organ dysfunction, respiratory failure, infection, APACHE score, therapy independently risk. Among whose score <15, rates observed treated other antibiotics (45.3% 7.7%; Central venous death Conclusion significant increase incidence CnSKP-BSIs during study period, rate found these patients. Exposure carbapenems severe illness development CnSKP-BSIs, resulted mortality.