Risk factors for infection of biofilm-positive Klebsiella pneumonia and prognosis of patients / 中华临床感染病杂志

ABSTRACT

Objective:To investigate risk factors for infection of biofilm-forming Klebsiella pneumonia and prognosis of patients. Methods:The clinical data of 125 patients with Klebsiella pneumoniae bloodstream infection admitted in Tianjin Medical University General Hospital from January to December 2019 were analyzed retrospectively. According to the presence of Klebsiella pneumoniae biofilm, patients were divided into biofilm positive group ( n=81) and biofim negative group ( n=44). In biofilm positive group 17 patients died (fatal group) and 64 survived (survival group) during 3-month follow-up. The antimicrobial resistance of the strains was analyzed, and multivariate logistic regression analysis was used to investigate the risk factors of biofilm-forming Klebsiella pneumoniae infection and the risk factors of death in biofilm positive group. Results:A total of 125 strains of Klebsiella pneumoniae were isolated from 125 patients, of which 81(64.80%) strains were biofilm positive. Antimicrobial resistance analysis showed that the resistance rate of biofilm positive group to aztreonam, amikacin, ciprofloxacin and levofloxacin was significantly higher than that in the biofilm negative group ( χ2=5.94, 4.03, 5.05 and 4.15, P<0.05). Multivariate logistic regression analysis showed that endotracheal intubation ( OR=3.460, 95% CI 2.890-14.445, P<0.05) and administration of immunosuppressants ( OR=6.945, 95% CI 1.160-21.567, P<0.05) within 3 months before infection were independent risk factors for biofilm-forming Klebsiella pneumoniae bloodstream infection. The use of tegacycline ( OR=4.886, 95% CI 1.123-21.263, P<0.05) within 3 months before death was independent risk factors for the death of biofilm-positive Klebsiella pneumoniae bloodstream infection. Conclusions:In order to reduce the incidence and fatality of biofilm-forming Klebsiella pneumoniae bloodstream infection, antibiotics should be used rationally and invasive procedures should be minimized.