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ORIGINAL RESEARCH article

Front. Cell. Infect. Microbiol.
Sec. Clinical Infectious Diseases
Volume 14 - 2024 | doi: 10.3389/fcimb.2024.1461325
This article is part of the Research Topic Advances in the Diagnosis and Management of Infectious Diseases View all 3 articles

The Prognostic value of Neutrophil to Lymphocyte Ratio in adult Carbapenem-Resistant Klebsiella pneumoniae infection: A Retrospective Cohort Study

Provisionally accepted
Zhongjie Wang Zhongjie Wang Zhe Yuan Zhe Yuan Renhua Li Renhua Li Keli Qian Keli Qian *
  • First Affiliated Hospital of Chongqing Medical University, Chongqing, China

The final, formatted version of the article will be published soon.

    Background: Systemic inflammatory indicators such as neutrophil to lymphocyte ratio (NLR) can effectively predict the prognosis of various inflammatory diseases. However, its prognostic effect on patients with carbapenem-resistant Klebsiella pneumoniae (CRKP) infection is little known. The objective of this study was to investigate the risk factors for mortality associated with CRKP infection and the clinical value of NLR in predicting prognosis in these patients. Methods: A total of 190 inpatients with CRKP infection from 1 January 2023 to 31 December, 2023 were enrolled in this study, including 73 fatal cases and 117 survival cases in hospital. The medical data and examination results of these patients were collected. A logistic analysis was performed to assess the association between the NLR on day of CRKP infection onset and all-cause mortality in hospital. Results: The overall mortality rate of patients with CRKP infection was 38.42% (73/190). Of the 190 patients, 91 were co-infected with carbapenem-resistant Acinetobacter baumannii / carbapenem-resistant Pseudomonas aeruginosa (CRAB/CRPA). Multifactor regression analysis confirmed carbapenems exposure in past 14 days, central line insertion and chronic Foley catheter requirement were independent risk factors for Carbapenem-resistant bacteria co-infection. The multivariate analysis shows that admission to an ICU, co-infection with CRAB/CRPA, and higher NLR were independent risk factors for the mortality in hospital, while appropriated treatments within 3 days was an independent protective factor. The area under the curve(AUC) of the NLR was 0.696, the cut-off value of the NLR was 10.73. Conclusions: The NLR on the day of CRKP infection onset, admission to an ICU, co-infection with CRAB/CRPA were identified as independent risk factors for the all-cause mortality of patients with CRKP infection, while appropriate treatment within 3 days was recognized as an independent protective factor. The NLR serves as a conveniently accessible and independent prognostic biomarker for patients with CRKP infection.

    Keywords: carbapenem-resistant Klebsiella pneumoniae, Risk factors, Neutrophil-to-lymphocyte ratio, Co-infection, prognosis

    Received: 08 Jul 2024; Accepted: 04 Nov 2024.

    Copyright: © 2024 Wang, Yuan, Li and Qian. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Keli Qian, First Affiliated Hospital of Chongqing Medical University, Chongqing, China

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