Risk Factors And Clinical Outcomes Of Carbapenem-resistant Klebsiella Pneumoniae Infections Of Critically Ill Patients

ObjectivesTo identify risk factors and clinical outcomes of patients infected by carbapenem-resistant Klebsiella pneumoniae (CRKP) in ICU, which can provide Clinical reference for prevention and control of bacterial drug resistance.MethodsStrains of Klebsiella pneumoniae were collected and analyzed about the source distribution in ICU. Experiments of drug sensitivity were carried out by agar dilution diffusion test methods. Using a case-control design, patients were divided into Carbapenem-resistant group and non Carbapenem-resistant group. Collect each patient clinical situations, use of antibiotics, and prognostic factors. Analysis with the resistance to carbapenem with klebsiella pneumoniae correlation, and mortality of two groups and related factors affecting the prognosis were analyzed.ResultsStrains of Klebsiella pneumoniae derived mainly from sputum (60%).From 2009 to 2011, carbapenem resistant rate increased annually. The risk factors of carbapenem-resistance include number of infection site and prior use of carbapenems. Compared with carbapenem-sensitive group, the mortality of carbapenem-resistant group was 46.90%, a little higher than the control group, but not statistically significant. Multiple organ dysfunction syndrome, malignancy, APACHE II score, and as well as prior exposure of the quinolone are the risk factors of mortality.ConclusionsCarbapenem-resistance is related to number of infection site and prior antibiotic exposure as well. The outcome of Klebsiella pneumoniae infected patients is related to multiple aspects. This study cannot indicate the direct relationship between case fatality rate and drug resistance, but have confirmed that the basic diseases condition and APACHE II score are directly connected with mortality. This study found that the quinolone exposure is also related to clinical outcome.