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- Title
Risk factors for and clinical outcomes of ceftazidime-avibactam-resistant carbapenem-resistant Klebsiella pneumoniae nosocomial infections: a single-center retrospective study.
- Authors
Liu, Xuejiao; Chu, Yanan; Yue, Huijie; Huang, Xiaohui; Zhou, Guohua
- Abstract
Purpose: The emergence of ceftazidime-avibactam (CZA) resistance in carbapenem-resistant Klebsiella pneumoniae (CRKP) has been increasingly reported in recent years. We aimed to identify the risk factors of CZA-resistant CRKP infection and assess clinical outcomes of the patients. Methods: The study retrospectively analyzed the clinical and microbiological data of patients with CRKP infection to identify risk factors, clinical features, and outcomes using multivariate logistic regression analysis. Results: A total of 103 patients with CRKP infection were enrolled in this study. Multivariate analysis showed previous renal replacement therapy (OR 3.966, 95% CI 1.301–12.090, P = 0.015) was an independent risk factor for CZA-resistant CRKP infection. The 28-day mortality was higher in patients infected with CZA-resistant CRKP (27.9%) than those with CZA-susceptible CRKP (7.1%) (P = 0.009). CZA-resistant CRKP infection (OR 20.308, 95% CI 1.461–282.293, P = 0.025), and mechanical ventilation (OR 14.950, 95% CI 1.034–216.212, P = 0.047) were independent predictors for 28-day mortality in patients with CRKP infection. Lower level of platelet count (OR 0.987, 95% CI 0.975–0.999, P = 0.032) on the day of CRKP infection onset was related to 28-day mortality. Kaplan–Meier curves showed that the CZA-resistant CRKP group had a shorter survival time than the CZA-susceptible CRKP group. Conclusion: The prevalence and mortality of CZA-resistant CRKP are still increasing. Strengthening the hospital infection control of renal replacement therapy and mechanical ventilation may help to prevent CZA-resistant CRKP.
- Subjects
CONFIDENCE intervals; MULTIPLE regression analysis; BLOOD platelets; CROSS infection; RETROSPECTIVE studies; KLEBSIELLA infections; TREATMENT effectiveness; MULTIDRUG resistance; DESCRIPTIVE statistics; KAPLAN-Meier estimator; ODDS ratio; DISEASE risk factors; EVALUATION
- Publication
Infection, 2022, Vol 50, Issue 5, p1147
- ISSN
0300-8126
- Publication type
Article
- DOI
10.1007/s15010-022-01781-3