1. Acute Exacerbation of Chronic Obstructive Pulmonary Disease Due to Carbapenem-Resistant Klebsiella pneumoniae -Induced Pneumonia: Clinical Features and Prognostic Factors.
- Author
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Ouyang P, Zhou Z, Pan C, Tang P, Long S, Liao X, Liu Q, and Xie L
- Subjects
- Humans, Carbapenems pharmacology, Carbapenems therapeutic use, Klebsiella pneumoniae, Retrospective Studies, Case-Control Studies, Anti-Bacterial Agents therapeutic use, Klebsiella, Prognosis, Risk Factors, Drug Resistance, Bacterial, Klebsiella Infections diagnosis, Klebsiella Infections drug therapy, Pulmonary Disease, Chronic Obstructive diagnosis, Pulmonary Disease, Chronic Obstructive drug therapy, Pneumonia drug therapy
- Abstract
Purpose: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is closely related to respiratory tract infection. The aim of this study was to investigate the clinical features and prognostic factors of CRKP-induced pneumonia in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients., Methods: A single-centre, retrospective case-control study on COPD patients hospitalized for acute exacerbation and CRKP-induced pneumonia was conducted from January 1, 2016, to December 31, 2022. The mortality rate of acute exacerbation due to CRKP-induced pneumonia was investigated. The patients were divided into the CRKP-induced pneumonic acute exacerbation (CRKPpAE) group and the non-CRKP-induced pneumonic acute exacerbation (non-CRKPpAE) group, and the clinical characteristics and prognostic factors were compared using univariate analysis and multivariate analysis., Results: A total of 65 AECOPD patients were included, composed of 26 patients with CRKPpAE and 39 patients with non-CRKPpAE. The mortality rate of CRKPpAE was 57.69%, while non-CRKPpAE was 7.69%. Compared with non-CRKPpAE, a history of acute exacerbation in the last year (OR=8.860, 95% CI: 1.360-57.722, p =0.023), ICU admission (OR=11.736, 95% CI: 2.112-65.207, p =0.005), higher NLR levels (OR=1.187, 95% CI: 1.037-1.359, p =0.013) and higher D-dimer levels (OR=1.385, 95% CI: 1.006-1.905, p =0.046) were independently related with CRKPpAE. CRKP isolates were all MDR strains (26/26, 100%), and MDR strains were also observed in non-CRKP isolates (5/39, 12.82%)., Conclusion: Compared with non-CRKPpAE, CRKPpAE affects the COPD patient's condition more seriously and significantly increases the risk of death., Competing Interests: The authors report no conflicts of interest in this work., (© 2024 Ouyang et al.)
- Published
- 2024
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