社区获得性碳青霉烯耐药肺炎克雷伯菌血流感染临床特征及预后

目的 探讨社区获得性碳青霉烯耐药肺炎克雷伯菌血流感染的临床特征及预后。方法 回顾性分析某院2017年2月—2021年3月社区获得性肺炎克雷伯菌血流感染病例，根据药敏结果分为碳青霉烯耐药组(CRKP组)和敏感组(CSKP组),比较两组患者临床特征以及30 d预后。结果 两组患者在冠心病或者心力衰竭、慢性阻塞性肺疾病、近期住院史、慢性肾功能不全、贫血、深静脉置管、机械通气、留置胃管、留置导尿管等方面比较，差异均有统计学意义，CRKP组均高于CSKP组(均P<0.05)。CRKP组患者30天病死率高于CSKP组(58.82%VS 9.68%,P<0.001)。结论 社区获得性碳青霉烯耐药肺炎克雷伯菌血流感染在有心肺肾基础疾病及近期住院史的患者中比例高，CRKP组预后差，临床需要重点关注。

Clinical characteristics and prognosis of community-acquired carbapenem-resistant Klebsiella pneumonia bloodstream infection

Objective To evaluate the clinical characteristics and prognosis of community-acquired carbapenem-resistant Klebsiella pneumoniae (CRKP) bloodstream infection. Methods Klebsiella pneumoniae bloodstream infection cases in a hospital from February 2017 to March 2021 were analyzed retrospectively, according to antimicrobial susceptibility testing results, they were divided into carbapenem resistance group (CRKP group) and carba-penem susceptibility group (CSKP group), clinical characteristics and 30-day prognosis of two groups of patients were compared. Results There were significant differences between two groups of patients in terms of coronary heart disease or heart failure, chronic obstructive pulmonary disease, recent hospitalization history, chronic renal insufficiency, anemia, deep vein catheterization, mechanical ventilation, indwelling gastric tube, and urinary catheterization, CRKP group was higher than CSKP group (all P < 0.05). The 30-day mortality in CRKP group was higher than that in CSKP group (58.82% vs 9.68% P < 0.001). Conclusion Community-acquired CRKP bloodstream infection accounts for a high proportion of patients with cardiopulmonary and renal underlying diseases as well as recent hospitalization history, prognosis of CRKP group is poor, which should be paid clinical attention.