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Mortality associated with carbapenem resistance in Klebsiella pneumoniae bloodstream infection: A propensity score–matched study

Published online by Cambridge University Press:  15 March 2024

Ling Wang ,
Chaoying Zeng ,
Xue Li ,
Yuqing Li ,
Zhihua Liu Open the ORCID record for Zhihua Liu [Opens in a new window]  and
Jing Hu
Ling Wang
Affiliation:
Department of Nosocomial Infection Administration, Zhujiang Hospital, Southern Medical University, Guangzhou, China
Chaoying Zeng
Affiliation:
Department of Laboratory, the First Affiliated Hospital of Hainan Medical University, Haikou, China
Xue Li
Affiliation:
Department of Nosocomial Infection Administration, Zhujiang Hospital, Southern Medical University, Guangzhou, China
Yuqing Li
Affiliation:
Department of Nosocomial Infection Administration, Zhujiang Hospital, Southern Medical University, Guangzhou, China
Zhihua Liu
Affiliation:
Department of Infectious Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China
Jing Hu*
Affiliation:
Department of Nosocomial Infection Administration, Zhujiang Hospital, Southern Medical University, Guangzhou, China
*
Corresponding author: Jing Hu; Email: hjalzh@smu.edu.cn
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Abstract

Objective:

Klebsiella pneumoniae are common pathogens causing bloodstream infection (BSI) that increasingly express carbapenem resistance worldwide. To date, no study has precisely investigated the impact of carbapenem resistance in K. pneumoniae (CRKP) BSI on mortality.

Methods:

This retrospective study included 87 patients with CRKP BSI and 321 patients with carbapenem-susceptible K. pneumoniae (CSKP) BSI from 2015 to 2020. Propensity score analyses with stabilized inverse probability of treatment weighting (IPTW-S) was applied to balance covariates. The hazard ratio for 30-day mortality associated with carbapenem resistance was estimated using Cox regression and Kaplan-Meier curves.

Results:

The 30-day crude mortality rates were 43.7% in patients with CRKP BSI and 17.8% in patients with CSKP BSI (P < .001). Age ≥55 years, underlying hematological malignancies and hemodialysis were independently associated with mortality in CRKP BSI. A skin or soft-tissue infection source, urinary catheter, and underlying chronic obstructive pulmonary disease were predictors of mortality in CSKP BSI. The group characteristics were well balanced after IPTW-S. The adjusted hazard ratio for 30-day mortality for CRKP BSI was 1.607 (interquartile range, 0.814–3.171).

Conclusions:

Carbapenem resistance was not associated with a significant increase in 30-day mortality in KP BSI; patient and disease factors were primary determinants of outcomes.

Information

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 45 , Issue 7 , July 2024 , pp. 839 - 846
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Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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