Table 1.
Characteristics of patients with carbapenem-resistant Klebsiella pneumoniae infections.
| Characteristic | All patients n = 191 | 30-day non-survivors n = 51 (26.7%) | 30-day survivors n = 140 (73.3%) | P value |
|---|---|---|---|---|
| Patient variables | ||||
| Male sex, n (%) | 142 (74.3) | 37 (72.5) | 105 (75.0) | 0.732 |
| Age, y, median (IQR) | 71 (61, 81) | 76 (65, 85) | 68 (60.75, 78) | 0.001 |
| Baseline disease or comorbidity, n (%) | ||||
| Diabetes mellitus | 58 (30.4) | 14 (27.5) | 44 (31.4) | 0.597 |
| Cardiovascular disease | 122 (63.9) | 30 (58.8) | 92 (65.7) | 0.381 |
| Cerebrovascular disease | 98 (51.3) | 19 (37.3) | 79 (56.4) | 0.020 |
| Renal disease | 47 (24.6) | 17 (33.3) | 30 (21.4) | 0.094 |
| Hematological Disease | 14 (7.3) | 2 (3.9) | 12 (8.6) | 0.360 |
| Digestive diseases | 58 (30.4) | 18 (35.3) | 40 (28.6) | 0.372 |
| Malignant solid tumor | 34 (17.8) | 12 (23.5) | 22 (15.7) | 0.215 |
| Surgery within the previous 30 days | 131 (68.6) | 33 (64.7) | 98 (70.0) | 0.486 |
| Immunosuppressant use | 169 (88.5) | 47 (92.2) | 122 (87.1) | 0.342 |
| ICU | 162 (84.8) | 44 (86.3) | 118 (84.3) | 0.735 |
| Clinical status, n (%) | ||||
| Respiratory failure | 49 (25.7) | 24 (47.1) | 25 (17.9) | <0.001 |
| Heart failure | 44 (23.0) | 16 (31.4) | 28 (20.0) | 0.101 |
| MODS | 16 (8.4) | 12 (23.5) | 4 (2.9) | <0.001 |
| SOFA score, median (IQR) | 3 (3, 5.5) | 5 (3, 8) | 3 (2, 5) | <0.001 |
| Invasive procedure and/or devices, n (%) | ||||
| Central venous catheterization | 181 (94.8) | 51 (100) | 130 (92.9) | 0.989 |
| Urinary catheterization | 167 (87.4) | 47 (92.2) | 120 (85.7) | 0.242 |
| Gastric catheterization | 165 (86.4) | 45 (88.2) | 120 (85.7) | 0.654 |
| CRRT | 18 (9.4) | 9 (17.6) | 9 (6.4) | 0.024 |
| Type of infections, n (%) | ||||
| Catheter-related infection | 7 (3.7) | 1 (2.0) | 6 (4.3) | 0.677 |
| Pneumonia | 120 (62.8) | 35 (68.6) | 85 (60.7) | 0.318 |
| Intra-abdominal infection | 15 (7.9) | 3 (5.9) | 12 (8.6) | 0.763 |
| Urinary tract infection | 27 (14.1) | 6 (11.8) | 21 (15.0) | 0.571 |
| Gastrointestinal infection | 3 (1.6) | 1 (2.0) | 2 (1.4) | 1 |
| Primary bloodstream infection | 18 (9.4) | 5 (9.8) | 13 (9.3) | 1 |
| Skin and soft-tissue infection | 4 (2.1) | 0 (0) | 4 (2.9) | 1 |
| CNS infection | 1 (0.5) | 0 (0) | 1 (0.7) | 1 |
| Laboratory variables from blood, Mean ± SD | ||||
| WBC, × 109/L | 11.20 ± 5.78 | 12.61 ± 6.46 | 10.68 ± 5.44 | 0.045 |
| ANC, × 109/L | 9.35 ± 5.22 | 10.63 ± 5.56 | 8.88 ± 5.02 | 0.044 |
| Lymphocyte, × 109/L | 9.46 ± 6.95 | 7.71 ± 6.2 | 10.10 ± 7.11 | 0.040 |
| Hemoglobin, g/L | 95 ± 21 | 90 ± 20 | 97 ± 22 | 0.046 |
| Platelet, × 109/L | 216 ± 134 | 162 ± 122 | 235 ± 134 | 0.001 |
| CRP, mg/L | 85 ± 59 | 101 ± 58 | 79 ± 58 | 0.028 |
| PCT, ng/mL | 2.70 ± 8.91 | 6.89 ± 16.31 | 1.22 ± 2.62 | 0.001 |
| Albumin, g/L | 32.3 ± 5.5 | 30.1 ± 6.3 | 33.1 ± 4.9 | 0.001 |
| Antimicrobial regimens a , n (%) | ||||
| Carbapenems | 92 (48.2) | 28 (54.9) | 64 (45.7) | 0.262 |
| BL-BLI b | 63 (33.0) | 20 (39.2) | 43 (30.7) | 0.270 |
| Broad spectrum β-lactams | 12 (6.3) | 0 (0) | 12 (8.6) | 0.038 |
| Ceftazidime-avibactam | 12 (6.3) | 0 (0) | 12 (8.6) | 0.038 |
| Tigecycline | 69 (36.1) | 24 (47.1) | 45 (32.1) | 0.059 |
| Polymyxin B | 12 (6.3) | 3 (5.9) | 9 (6.4) | 1 |
| Aminoglycosides | 36 (18.8) | 4 (7.8) | 32 (22.9) | 0.021 |
| Fosfomycin | 47 (24.6) | 6 (11.8) | 41 (29.3) | 0.013 |
| Fluoroquinolones | 13 (6.8) | 2 (3.9) | 11 (7.9) | 0.519 |
| Others c | 32 (16.8) | 6 (11.8) | 26 (18.6) | 0.269 |
| Number of anti-KP drugs, n (%) | 0.022 | |||
| 1 | 47 (24.6) | 17 (33.3) | 30 (21.4) | |
| 2 | 93 (48.7) | 26 (51.0) | 67 (47.9) | |
| 3 | 51 (26.7) | 8 (15.7) | 43 (30.7) | |
| Appropriate treatments in 3 days, n (%) | 116 (60.7) | 23 (45.1) | 93 (66.4) | 0.008 |
| Outcomes of infection d | ||||
| Effective in 7 days, n (%) | 78 (41.1) | 12 (23.5) | 66 (47.5) | 0.004 |
| Effective in 15 days, n (%) | 127 (66.5) | 15 (29.4) | 112 (80.6) | <0.001 |
| Cost of antimicrobial agents e , USD | 7697 ± 10516 | 5648 ± 6830 | 8459 ± 11521 | 0.112 |
| Cost of medications e , USD | 16297 ± 17920 | 15048 ± 14072 | 16762 ± 19181 | 0.560 |
Antimicrobial regimens referred to the antibiotics intended to be used against CRKP administered at the same time within 7 days after CRKP was detected.
β-lactam/β-lactamase inhibitors (BL-BLI) included cefoperazone-sulbactam and piperacillin-tazobactam.
Other drugs included tetracyclines and sulfamethoxazole-trimethoprim.
The outcomes of infection were defined as effective (cure or improvement) or noneffective treatment (stable or deterioration) according to clinical, radiological, and laboratory findings.
USD1 = CNY6.5 in year 2021.
IQR, interquartile range; ICU, intensive care unit; MODS, multiple organ dysfunction syndrome; SOFA, Sequential Organ Failure Assessment; CRRT, continuous renal replacement therapy; CNS, central nervous system; WBC, white blood count; ANC, absolute neutrophil count; CRP, c-reactive protein; PCT, procalcitonin; KP, Klebsiella pneumonia.