医院获得性肺炎克雷伯菌血流感染特点及预后危险因素分析

摘要

Objective To investigate the clinical characteristics of hospital acquired Klebsiella pneumoniae bloodstream infection and analyze the risk factors affecting the prognosis of patients with Klebsiella pneumoniae bloodstream infection.Methods Retrospective analysis was performed on the clinical characteristics and prognosis of 350 patients with Klebsiella pneumoniae bloodstream infection admitted by each department of our hospital from February 2015 to February 2018,and Logistic regression analysis was performed to analyze the risk factors affecting the prognosis of patients with Klebsiella pneumoniae bloodstream infection.Results Secondary bloodstream infection (51.43％) was found in Klebsiella pneumoniae bloodstream infection in our hospital.The infection rate of carbapenem-resistant Klebsiella pneumoniae (CRKP) was 42.00％ and the mortality rate was 17.43％.Logistic regression analysis showed that diabetes mellitus (OR=2.625,P=0.015),CRKP infection (OR=5.089,P=-0.020),and central venous catheterization (OR=3.766,P=0.029) were risk factors for the prognosis of patients with hospital acquired Klebsiella pneumoniae bloodstream infection.Conclusion Patients with Klebsiella pneumoniae bloodstream infection in our hospital have a higher mortality rate,and diabetes,CRKP infection,and central venous catheterization are risk factors for poor prognosis.%目的 了解医院获得性肺炎克雷伯菌血流感染的临床特点,分析影响肺炎克雷伯菌血流感染患者预后的危险因素.方法 回顾性分析2015年2月至2018年2月本院各科室收治的经临床确诊为肺炎克雷伯菌血流感染的350例患者临床特点和病情转归,Logistic回归分析影响肺炎克雷伯菌血流感染患者预后的危险因素.结果 本院肺炎克雷伯菌血流感染中以继发性血流感染(51.43％)为主,耐碳青霉烯类肺炎克雷伯菌(CRKP)感染率为42.00％,死亡率为17.43％.Logistic多因素回归分析示糖尿病(OR=2.625,P=0.015)、CRKP感染(OR=5.089,P=0.020)、中心静脉置管(OR=3.766,P=0.029)是影响医院获得性肺炎克雷伯菌血流感染患者预后的危险因素.结论 本院肺炎克雷伯菌血流感染患者院内死亡率较高,合并糖尿病、CRKP感染、中心静脉置管的应用是导致患者不良预后的危险因素.