摘要
目的回顾性分析重症医学科(intensive care unit,ICU)肺炎克雷伯菌(Klebsiella pneumonia,KP)血流感染的临床特征和预后,以指导临床预防和治疗。方法通过分析山东第一医科大学第一附属医院2018年6月—2023年5月ICU收治的74例肺炎克雷伯菌血流感染(Klebsiella pneumoniae bloodstream infection,KP BSI)患者临床资料,对碳青霉烯类耐药肺炎克雷伯菌(carbapenem-resistant Klebsiella pneumoniae,CRKP)和碳青霉烯类敏感肺炎克雷伯菌(carbapenem-susceptible Klebsiella pneumoniae,CSKP)进行病例对照研究。结果ICU中CSKP血流感染主要是原发性感染(26/48,54.17%),CRKP血流感染主要由肺部感染导致(13/26,50.00%)。CSKP血流感染组的28 d死亡率为35.42%(17/48),而CRKP血流感染组的28 d死亡率更高,为61.54%(16/26),差异有统计学意义(P<0.05)。机械通气和连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)是KP BSI 28 d死亡的独立危险因素(OR=27.303、4.697,P<0.05)。结论CRKP血流感染主要由肺部感染导致,其28 d死亡率更高,机械通气和CRRT是影响患者预后的独立危险因素。
Objective To retrospectively analyze the clinical features and prognosis of Klebsiella pneumoniae bloodstream infection in intensive care unit(ICU),and to guide clinical prevention and treatment.Methods The clinical data of 74 patients with Klebsiella pneumoniae bacteremia infection(KP BSI)admitted to the department of ICU of the First Affiliated Hospital of Shandong First Medical University from June 2018 to May 2023 were analyzed.Carbapenem-resistant Klebsiella pneumoniae(CRKP)and carbapenem-susceptible Klebsiella pneumoniae(CSKP)were case-control studies.Results In ICU,CSKP bloodstream infection was mainly primary infection(26/48,54.17%),while CRKP bloodstream infection was mainly caused by pulmonary infection(13/26,50.00%).The 28 d mortality rate was 35.42%(17/48)in the CSKP bloodstream infection group and 61.54%(16/26)in the CRKP bloodstream infection group,the difference was statistically significant(P<0.05).Mechanical ventilation and continuous renal replacement therapy(CRRT)were independent risk factors for 28 d death in KP BSI(OR=27.303,4.697,P<0.05).Conclusion CRKP bloodstream infection is mainly caused by pulmonary infection,with a higher mortality at 28 d.Mechanical ventilation and CRRT are independent risk factors affecting the prognosis of patients.
作者
李冲
张富祥
张玉可
赵倩楠
吕振平
姜志明
LI Chong;ZHANG Fuxiang;ZHANG Yuke;ZHAO Qiannan;LYU Zhenping;JIANG Zhiming(RICU,the First Affiliated Hospital of Shandong First Medical University,Jinan Shandong 250014,China)
出处
《中国卫生标准管理》
2024年第19期66-70,共5页
China Health Standard Management
基金
山东省医药卫生科技发展计划项目(202003021296)。
关键词
重症医学科
肺炎克雷伯菌
血流感染
临床特征
危险因素
预后
intensive care unit
Klebsiella pneumoniae
bloodstream infection
clinical features
risk factor
prognosis
