Clinical Characteristics And Risk Factors Of XDR-klebsiella Pneumoniae LRTI In RICU

Objective:To analyze the clinical characteristics and risk factors of XDR-Klebsiella pneumoniae lower respiratory tract infection(LRTI)in RICU.Methods:A retrospective analysis was made to the clinical material of 21 patients with LRTI caused by XDR-Klebsiella pneumoniae admitted to RICU during 2016.06~2017.02,31 patients with LRTI caused by MDR-Klebsiella pneumoniae as the control group.Clinical characteristics(age,sex,underlying diseases,etc.),risk factors,treatment and prognosis was studied.Results:1.The average age of 21 patients with XDR-Kpn LRTI was 75.38±11.61 years old.The average age of the control group(31 cases of MDR-KPn LRTI)was 69.79±14.61 years old.2.The incidence of XDR-Kpn LRTI patients was mainly in two peaks of 2016.12~2017.01.3.The majority of the two groups of patients had underlying diseases,and some patients had more than two underlying diseases.4.Univariate analysis showed that the time stayed in RICU(≥ 7 days),the application of broad-spectrum antibiotics for more than 7 days before Kpn was isolated,high APACHEII score(≥20)and the conducted of tracheal intubation or incision for more than 7 days were risk factors of XDR-Kpn LRTI in RICU.5.The rate of deterioration(death and automatic discharge ratio)of the XDR-Kpn induced LRTI patients in our RICU was up 95.2%.The treatment of XDR-Kpn LRTI was mainly carbapenems and tigecycline,and the effect on these patients was poor.Conclusion:1.The XDRKpn LRTI patients in RICU were generally older and there were more males than females.They had more basic diseases and poor prognosis.2.Stay in the RICU time(≥7 days),the application of broad-spectrum antibiotics before the separation of Kpn≥7 days,high APACHEII score(≥20)and Tracheal intubation or incision≥7 days are common susceptibility factors of patients with XDRKpn nosocomial infection.3.The use of carbapenems and tigecycline as a combination of anti-infective regimens for the treatment of XDRKpn’s LRTI was poor.