Development of prediction models for carbapenem-resistant Klebsiella pneumoniae acquisition and prognosis in adult patients
ObjectivesTo explore the risk factors and clinical outcomes of carbapenem-resistant Klebsiella pneumoniae (CRKP) infection and establish nomograms to predict the probability of CRKP infection and mortality in adult patients.MethodsPatients infected with KP from August 2019 to April 2021 in a tertiar...
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Frontiers Media S.A.
2024-11-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2024.1439116/full |
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| author | Huijuan Yao Yu Yang Huimin Yao Shuhong Bu Lixia Li Fang Wang Jian Zhang Jihui Chen |
| author_facet | Huijuan Yao Yu Yang Huimin Yao Shuhong Bu Lixia Li Fang Wang Jian Zhang Jihui Chen |
| author_sort | Huijuan Yao |
| collection | DOAJ |
| description | ObjectivesTo explore the risk factors and clinical outcomes of carbapenem-resistant Klebsiella pneumoniae (CRKP) infection and establish nomograms to predict the probability of CRKP infection and mortality in adult patients.MethodsPatients infected with KP from August 2019 to April 2021 in a tertiary hospital in Shanghai were enrolled. Risk factors associated with CRKP and 30-day mortality were identified using multivariate logistic regression analysis and Cox regression analysis.ResultsOverall, 467 patients with KP infection were enrolled, wherein 210 (45.0%) patients were infected with CRKP and 257 (55.0%) patients with carbapenem-susceptible K. pneumoniae (CSKP). Five factors, namely Charlson’s Comorbidity Index (CCI) ≥ 3, the use of central venous catheterization, prior hospitalization during the 3 months before infection, and previous exposure to carbapenems and broad-spectrum β-lactams, were found to be independently associated with CRKP infection. Based on these parameters, the nomogram showed a better performance as indicated by C-index of 0.94 (95% confidence interval [CI]: 0.92–0.96) and well-fitted calibration curves. CRKP was independently associated with 30-day mortality. Multivariate Cox regression analysis revealed that age ≥65 years, higher CCI scores, higher Sequential Organ Failure Assessment scores, the presence of respiratory failure, albumin levels ≤30 g/L, and non-appropriate treatments in 3 days, were associated with 30-day mortality.ConclusionThe predictive nomogram established in this study can facilitate the clinicians to make better clinical decisions when treating patients with KP infection. |
| format | Article |
| id | doaj-art-4e88703b7466449c8db7f40f8e59658f |
| institution | OA Journals |
| issn | 1663-9812 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj-art-4e88703b7466449c8db7f40f8e59658f2025-08-20T02:18:58ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122024-11-011510.3389/fphar.2024.14391161439116Development of prediction models for carbapenem-resistant Klebsiella pneumoniae acquisition and prognosis in adult patientsHuijuan Yao0Yu Yang1Huimin Yao2Shuhong Bu3Lixia Li4Fang Wang5Jian Zhang6Jihui Chen7Department of Pharmacy, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Pharmacy, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaSchool of Traditional Chinese Medicine, Jilin Agriculture Science and Technology University, Jilin, ChinaDepartment of Pharmacy, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Pharmacy, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Pharmacy, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Pharmacy, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Pharmacy, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaObjectivesTo explore the risk factors and clinical outcomes of carbapenem-resistant Klebsiella pneumoniae (CRKP) infection and establish nomograms to predict the probability of CRKP infection and mortality in adult patients.MethodsPatients infected with KP from August 2019 to April 2021 in a tertiary hospital in Shanghai were enrolled. Risk factors associated with CRKP and 30-day mortality were identified using multivariate logistic regression analysis and Cox regression analysis.ResultsOverall, 467 patients with KP infection were enrolled, wherein 210 (45.0%) patients were infected with CRKP and 257 (55.0%) patients with carbapenem-susceptible K. pneumoniae (CSKP). Five factors, namely Charlson’s Comorbidity Index (CCI) ≥ 3, the use of central venous catheterization, prior hospitalization during the 3 months before infection, and previous exposure to carbapenems and broad-spectrum β-lactams, were found to be independently associated with CRKP infection. Based on these parameters, the nomogram showed a better performance as indicated by C-index of 0.94 (95% confidence interval [CI]: 0.92–0.96) and well-fitted calibration curves. CRKP was independently associated with 30-day mortality. Multivariate Cox regression analysis revealed that age ≥65 years, higher CCI scores, higher Sequential Organ Failure Assessment scores, the presence of respiratory failure, albumin levels ≤30 g/L, and non-appropriate treatments in 3 days, were associated with 30-day mortality.ConclusionThe predictive nomogram established in this study can facilitate the clinicians to make better clinical decisions when treating patients with KP infection.https://www.frontiersin.org/articles/10.3389/fphar.2024.1439116/fullcarbapenem-resistantKlebsiella pneumoniaeinfectionnomogramprognosis |
| spellingShingle | Huijuan Yao Yu Yang Huimin Yao Shuhong Bu Lixia Li Fang Wang Jian Zhang Jihui Chen Development of prediction models for carbapenem-resistant Klebsiella pneumoniae acquisition and prognosis in adult patients Frontiers in Pharmacology carbapenem-resistant Klebsiella pneumoniae infection nomogram prognosis |
| title | Development of prediction models for carbapenem-resistant Klebsiella pneumoniae acquisition and prognosis in adult patients |
| title_full | Development of prediction models for carbapenem-resistant Klebsiella pneumoniae acquisition and prognosis in adult patients |
| title_fullStr | Development of prediction models for carbapenem-resistant Klebsiella pneumoniae acquisition and prognosis in adult patients |
| title_full_unstemmed | Development of prediction models for carbapenem-resistant Klebsiella pneumoniae acquisition and prognosis in adult patients |
| title_short | Development of prediction models for carbapenem-resistant Klebsiella pneumoniae acquisition and prognosis in adult patients |
| title_sort | development of prediction models for carbapenem resistant klebsiella pneumoniae acquisition and prognosis in adult patients |
| topic | carbapenem-resistant Klebsiella pneumoniae infection nomogram prognosis |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2024.1439116/full |
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