上海预防医学2025，Vol.37Issue(4)：296-300,5.DOI:10.19428/j.cnki.sjpm.2025.24815
耐碳青霉烯类肺炎克雷伯菌血流感染患者30d及以内死亡的相关因素分析
An analysis of risk factors for mortality in patients with bloodstream infections caused by carbapenem-resistant Klebsiella pneumoniae
摘要
Abstract
[Objective]To explore the clinical characteristics and risk factors for 30-day mortality in hospitalized patients with bloodstream infections(BSI)caused by carbapenem-resistant Klebsiella pneumoniae(CRKP).[Methods]Data were obtained retrospectively from the electronic medical records of inpatients at a tertiary A-grade hospital in Shanghai from January 2016 to December 2023.The collected variables included age,gender,department,surgical treatment,empirical antibiotic therapy,Pitt Bacteremia score(PBS),Charlson comorbidity index(CCI),INCREMENT-CPE score(ICS),length of hospital stay,the time from CRKP-BSI to discharge and,etc.The follow-up period ended upon discharge,with the follow-up outcomes defined as in-hospital mortality or discharge.The endpoint was defined as death within 30 days(including day 30)caused by CRKP-BSI or infection-related complications.Patients who survived within 30 days after CRKP-BSI were classified into the survival group,while those who died within 30 days were classified into the death group.Independent risk factors for 30-day mortality in patients with CRKP-BSI were analyzed using univariate and multivariate Cox regression analysis.[Results]A total of 71 hospitalized patients with CRKP-BSI,comprising 51 males and 20 females,with an average age of(65.12±18.25)years,were included during the study period.The M(P25,P75)of hospital stay were 37.00(24.00,56.00)days,and M(P25,P75)of the duration from CRKP-BSI to discharge or death were 18.00(7.00,35.00)days.There were 20 deaths(28.17%)in the death group and 51 survivors(71.83%)in the survival group.The results of multivariate Cox regression analysis showed that the ICS as an independent risk factor for 30-day mortality in CRKP-BSI patients(HR=1.379,95%CI:1.137‒1.671,P=0.001).Each 1-point increase in the ICS was associated with a 37.9%increase in the risk of mortality.[Conclusion]The ICS is found to be a risk factor for 30-day mortality in patients with CRKP-BSI,which may facilitate the prediction for the risk of 30-day mortality and thereby support clinical decision-making for patients with CRKP-BSI.关键词
耐碳青霉烯类肺炎克雷伯菌/血流感染/死亡率/危险因素/医院Key words
carbapenem-resistant Klebsiella pneumoniae/bloodstream infection/mortality/risk factor/hospital分类
医药卫生引用本文复制引用
朱秋丽,耿苗苗,卫菊,沈芸,胡丹,陈春霞,陈海威,孙喆..耐碳青霉烯类肺炎克雷伯菌血流感染患者30d及以内死亡的相关因素分析[J].上海预防医学,2025,37(4):296-300,5.基金项目
上海交通大学医学院院感科研项目(Jyyg2213) （Jyyg2213）
上海市松江区科技攻关(医药卫生领域)项目(2024SJKJGG053) （医药卫生领域）
