| Summary: | An optimal antimicrobial regimen for the treatment of patients with carbapenem-resistant <i>Klebsiella pneumoniae</i> (CRKP) bloodstream infection (BSI) is currently unavailable. This study aimed to identify the appropriate antibiotics and the risk factors of all-cause mortality for CRKP BSI patients. This retrospective cohort study included the hospitalized patients with CRKP BSI. Primary outcome was 30-day all-cause mortality. Cox regression analysis was used to evaluate the risk factors of 30-day mortality. A total of 89 patients were included with a 30-day mortality of 52.1%. A total of 52 (58.4%) patients were treated with appropriate antimicrobial regimens and 58 (65.2%) isolates carried <i>bla</i><sub>KPC-2</sub> genes. Microbiologic eradication within 7 days (adjusted hazard ratio [HR] = 0.09, <i>p</i> < 0.001), platelet count (per 1 × 10<sup>4</sup>/mm<sup>3</sup>, adjusted HR = 0.95, <i>p</i> = 0.002), and Pitt bacteremia scores (adjusted HR = 1.40, <i>p</i> < 0.001) were independently associated with 30-day all-cause mortality. No effective antimicrobial regimens were identified. In conclusion, risk factors of 30-day mortality in patients with CRKP BSI included microbiologic eradication > 7 days, lower platelet count, and a higher Pitt bacteremia score. These findings render a new insight into the clinical landscape of CRKP BSI.
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