碳青霉烯类耐药肺炎克雷伯菌致血流感染危险因素及预后分析

目的分析碳青酶烯类耐药肺炎克雷伯菌(CRKP)所致血流感染的临床危险因素和预后转归,为院感防控提供参考。方法回顾性分析河南省人民医院2017年7月—2019年7月281例肺炎克雷伯菌血流感染患者的临床资料,分析CRKP感染的危险因素及预后转归。结果281例肺炎克雷伯菌血流感染患者中CRKP感染124例,碳青霉烯类敏感肺炎克雷伯菌(CSKP)感染157例。CRKP血流感染患者死亡率及住院天数均高于CSKP血流感染患者(P<0.05)。行侵入性治疗、使用碳青霉烯类抗菌药物及酶抑制剂是CRKP感染的危险因素。CRKP感染预后较差。结论CRKP血流感染治愈率低,患者预后差。使用抗菌药物及行侵入性治疗可增加CRKP血流感染的风险。感染后经验用药合理仍然是其预后良好的保护性因素。

Risk factors and prognosis of bloodstream infection caused by carbapenem-resistant Klebsiella pneumoniae

Objective To analyze the risk factors and prognosis of bloodstream infection caused by carbapenemresistant Klebsiella pneumoniae(CRKP),and to provide a reference for the control and prevention of nosocomial infection.Methods The clinical data of 281 patients with bloodstream infection caused by Klebsiella pneumoniae from July 2017 to July 2019 in Henan Provincial People's Hospital were analyzed retrospectively.The risk factors and prognosis of bloodstream infetction caused by CRKP was analyzed.Results There were 124 CRKP infection cases and 157 carbapenem-sensitive Klebsiella pneumoniae(CSKP)infection cases.The mortality rate and inpatient day in CRKP infection cases were higher than those in CSKP infection cases(P<0.05).The risk factors of bloodstream infection caused by CRKP included using antibiotics(carbapenems and enzyme inhibitors)before infection and invasive treatment.The prognosis of CRKP infection was poor.Conclusions Bloodsteam infection caused by CRKP has low cure rate and poor prognosis.Using antibiotics before infection and invasive treatment are the risk factors of bloodstream infection caused by CRKP.The rational use of antibiotics after infection is a protective factor for good prognosis.