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Adipose tissue is a predictor of 30-days mortality in patients with bloodstream infection caused by carbapenem-resistant Klebsiella pneumoniae.
Ying, Piaopiao; Chen, Jiajing; Ye, Yinchai; Ye, Jianzhong; Cai, Weiyang.
  • Ying P; Department of General Medicine, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.
  • Chen J; Department of Pneumology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
  • Ye Y; Department of General Medicine, The Health Center of Eryuan Town, Wencheng County, Wenzhou, China.
  • Ye J; Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China. jzye89@163.com.
  • Cai W; Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China. caiweiyang@sjtu.edu.cn.
BMC Infect Dis ; 22(1): 173, 2022 Feb 21.
Article in English | MEDLINE | ID: covidwho-1699389
ABSTRACT

BACKGROUND:

Prevalence of carbapenem-resistant Klebsiella pneumoniae (CRKP) bloodstream infection with high mortality has attached physicians' attention. High visceral adipose tissue (VAT) and high subcutaneous adipose tissue (SAT) were confirmed by previous studies that were closely related to increased pneumonia severity, more complications, and higher mortality in COVID-19. Thus, we speculate that CT-quantified body composition may also be connected to all-cause mortality and bacterial clearance in patients with CRKP bloodstream infection (BSI).

METHODS:

We investigated the associations of CT-quantified body composition with the mortality of CRKP bloodstream infectious patients. All CT images were obtained at the level of the L3/4 spinal level. The prognostic value of the body composition was analyzed using the Cox regression model, and precise clinical nomograms were established.

RESULTS:

72 eligible patients both suffered from CRKP bloodstream infection and performed abdominopelvic CT were included. Factors associated with 30-day all-in hospital mortality included total adipose tissue (TAT) [adjusted hazard ratio (HR) = 1.028, 95% confidence interval (CI), 1.003-1.053; P = 0.025], age [HR = 1.030, 95% CI, 1.000-1.061; P = 0.047] and SOFA scores [HR = 1.138, 95% CI 1.049-1.263; P = 0.002]. Compared with low-VAT, patients with high-VAT show a strikingly poor prognosis in both 30-day all-cause mortality (P = 0.0108, Fig. 2A) and 30-day CRKP BSI mortality (P = 0.0049, Fig. 2C). The results of TAT were similar to VAT.

CONCLUSIONS:

Our study suggested that CT-derived body composition could be a credible and effective alternative to assess the prognosis of patients with BSI owing to CRKP. CT-quantified TAT, age, and SOFA scores were independently associated with 30-day all-cause mortality in these severe infectious patients, while skeletal muscle did not have obvious statistical significance.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Klebsiella Infections / Bacteremia / Sepsis / COVID-19 Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: S12879-022-07108-9

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Klebsiella Infections / Bacteremia / Sepsis / COVID-19 Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: S12879-022-07108-9