Risk Factors of 30-Day All-Cause Mortality in Patients with Carbapenem-Resistant <i>Klebsiella pneumoniae</i> Bloodstream Infection

• Main Authors: Keh-Sen Liu, Yao-Shen Tong, Ming-Tsung Lee, Hung-Yu Lin, Min-Chi Lu
• Format: Article
• Language: English
• Published: MDPI AG 2021-06-01
• Series: Journal of Personalized Medicine
• Subjects: bacteremia; carbapenemase; carbapenem-resistant <i>Enterobacteriaceae</i>; <i>Klebsiella pneumoniae</i>; mortality; risk factors
• Online Access: https://www.mdpi.com/2075-4426/11/7/616

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>_KPC-2 genes. Microbiologic eradication within 7 days (adjusted hazard ratio [HR] = 0.09, <i>p</i> < 0.001), platelet count (per 1 × 10⁴/mm³, 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.