The Risk Factors of Carbapenem-Resistant Klebsiella pneumoniae Infection: A Single-Center Chinese Retrospective Study

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Abstract
Objective: The present study aims to explore potential infection and death risk factors in patients infected with carbapenem-resistant Klebsiella pneumoniae (CRKP). Methods: A retrospective case-control study was performed at Beijing Shijitan Hospital, China. The clinical and microbiological data of patients infected with K. pneumoniae (K.pn) were collected; the clinical characteristics of patients infected with carbapenem-susceptible K.pn and CRKP were analyzed using logistic regression analysis. Results: CRKP infection was significantly associated with prior carbapenem use (odds ratio [OR] and 95% credibility interval [CI]: 5.161 [1.840– 32.233], P < 0.001), the use of more than three types of antibiotics for seven or more days (OR and 95% CI: 9.681 [2.662– 18.122], P < 0.001), tracheotomy (OR and 95% CI: 5.015 [2.343– 11.724], P < 0.001), and intensive care unit (ICU) stay (OR and 95% CI: 6.322 [2.02– 12.231], P < 0.001). The risk of death in patients with CRKP infection was significantly associated with older age (OR and 95% CI of 70– 80 years: 8.894 [1.972– 67.346], P < 0.001; ≥ 80 years: 15.234 [2.072– 93.452], P < 0.001), renal dysfunction (OR and 95% CI: 1.672 [1.104– 7.451], P = 0.016), tracheotomy (OR and 95% CI: 2.051 [1.217– 11.235], P = 0.002), and ICU stay (OR and 95% CI: 3.043 [2.174– 18.453], P < 0.001). Conclusion: Prior to carbapenem use, older age, renal dysfunction, tracheotomy, and ICU stay were independent risk factors for death in patients infected with CRKP.

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