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. 2025 Dec 25;26(1):184.
doi: 10.1186/s12879-025-12401-4.

Predictors of 30-day mortality in critically ill patients with bloodstream infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae: a five-year retrospective study

Mei-Yuan Teo  1 , Shaw-Woei Leu  1 , Li-Chung Chiu  1 , Ko-Wei Chang  1 , Bing-Chen Wu  1 , Li-Pang Chuang  1 , Shih-Wei Lin  1 , Meng-Jer Hsieh  1 , Huang-Pin Wu  2 , Kuo-Chin Kao  1   3 , Han-Chung Hu  4   5
Affiliations

Predictors of 30-day mortality in critically ill patients with bloodstream infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae: a five-year retrospective study

Mei-Yuan Teo et al. BMC Infect Dis. .

Abstract

Background: Infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) are increasingly contributing to mortality in ICU patients. The study aimed to evaluate outcomes, identify mortality predictors, and assess antibiotic strategies for treating KPC-Kp bloodstream infections (BSIs) in critically ill ICU patients.

Materials and methods: This retrospective study at Chang Gung Memorial Hospital, Taiwan, from January 2017 to December 2021, analyzed 168 adult ICU patients with KPC-Kp BSIs. All patients experienced respiratory failure and were on mechanical ventilation.

Results: The 30-day mortality rate was 61.9%. Patients who died had higher Pitt bacteremia (7.0 ± 2.6 vs. 4.2 ± 2.9, P < 0.001) and SOFA scores (12.0 ± 4.1 vs. 6.2 ± 3.8, P < 0.001), greater need for renal replacement therapy (27.9% vs. 9.4%, P < 0.002), and higher intra-abdominal infection prevalence (9.6% vs. 0%, P < 0.001). Lower platelet counts (93.7 ± 84.7 vs. 171.1 ± 120.2, P < 0.001) and higher CRP levels (131.3 ± 92.3 vs. 88.7 ± 81.0, P < 0.003) were observed in deceased patients. Multivariate analysis identified CRP levels and SOFA scores as independent mortality predictors, while ceftazidime-avibactam treatment and appropriate antibiotic therapy within 48 h post-BSI onset correlated with better outcomes.

Conclusions: Early appropriate antibiotic treatments and ceftazidime-avibactam use are crucial for reducing mortality in critically ill ICU patients.

Clinical trial number: Not applicable.

Supplementary Information: The online version contains supplementary material available at 10.1186/s12879-025-12401-4.

Keywords: Klebsiella pneumoniae carbapenemase; Appropriate antibiotic treatments; Blood-stream infections; Carbapenem-resistant; Critically ill patients; Mortality rate.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was reviewed and approved by the Institutional Review Board of Chang Gung Memorial Hospital (Approval number: 201801433B0). Written informed consent for participation was not required for this study in accordance with national legislation and the institutional requirements. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Study flow chart
Fig. 2
Fig. 2
Kaplan-meier survival curves comparing survival outcomes in critically Ill patients with Klebsiella pneumoniae carbapenemase-producing K. pneumoniae induced blood-stream infections: (A) patients treated with or without ceftazidime-avibactam regimen; (B) patients with or without appropriate antibiotic treatment within 48 h after blood-stream infections onset
See this image and copyright information in PMC

References

    1. Hsu JY, Chuang YC, Wang JT, Chen YC, Hsieh SM. Healthcare-associated carbapenem-resistant Klebsiella pneumoniae bloodstream infections: risk factors, mortality, and antimicrobial susceptibility, 2017–2019. J Formos Med Assoc. 2021;120(11):1994–2002. - DOI - PubMed
    1. Kohler PP, Volling C, Green K, Uleryk EM, Shah PS, McGeer A. Carbapenem Resistance, initial antibiotic Therapy, and mortality in Klebsiella pneumoniae bacteremia: A systematic review and Meta-Analysis. Infect Control Hosp Epidemiol. 2017;38(11):1319–28. - DOI - PubMed
    1. Satlin MJ, Chen L, Patel G, Gomez-Simmonds A, Weston G, Kim AC et al. Multicenter clinical and molecular epidemiological analysis of bacteremia due to carbapenem-resistant enterobacteriaceae (CRE) in the CRE epicenter of the United States. Antimicrob Agents Chemother 2017;61(4). - PMC - PubMed
    1. Potter RF, D’Souza AW, Dantas G. The rapid spread of carbapenem-resistant Enterobacteriaceae. Drug Resist Updat. 2016;29:30–46. - DOI - PMC - PubMed
    1. Jean SS, Lee NY, Tang HJ, Lu MC, Ko WC, Hsueh PR. Carbapenem-Resistant Enterobacteriaceae infections: Taiwan aspects. Front Microbiol. 2018;9:2888. - DOI - PMC - PubMed

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