关键词: 高毒力肺炎克雷伯菌, 碳青霉烯耐药, 感染, 危险因素

Abstract:

Objective To investigate the clinical characteristics of patients infected with carbapenem-resistant hypervirulent Klebsiella pneumoniae（CR-hvKP）and the risk factors for 30 d mortality in these patients，and to provide a reference for the formulation of targeted measures in clinical practice. Methods A total of 150 patients with positive CR-hvKP etiology and clinically diagnosed as CR-hvKP infection in the People's Hospital of Deyang from July 2020 to July 2023 were enrolled. All the patients' clinical data were collected，and they were classified into death group（35 cases）and survival group（115 cases）based on the 30 d mortality. Laboratory determination results of the patients were collected，and Cox proportional hazard regression analysis was used to evaluate the risk factors for the 30 d mortality of patients. Results The patients with CR-hvKP infection were mainly distributed in the neurology department（27.3%），and the main disease type was respiratory system infection（65.3%）. Mechanical ventilation，tracheal intubation and admission to intensive care unit（ICU）were independent risk factors for 30 d mortality in patients with CR-hvKP infection，while the use of tigecycline was a protective factor for the 30 d mortality of patients（P<0.05）. The 30 d survival rates of patients with mechanical ventilation（Log-rank χ²=5.985，P=0.014），tracheal intubation（Log-rank χ²=8.890，P=0.003），no history of tigecycline use（Log-rank χ²=4.378，P=0.036）and admission to ICU（Log-rank χ²=4.848，P=0.028） were lower. Conclusions Mechanical ventilation，tracheal intubation，the use of tigecycline and admission to ICU are independent risk factors for 30 d mortality in patients with CR-hvKP infection. Clinically，targeted prevention and treatment measures should be formulated based on these risk factors to reduce the mortality of infected patients.

Key words: Hypervirulent Klebsiella pneumoniae, Carbapenem resistance, Infection, Risk factor