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ORIGINAL RESEARCH article

Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1499057

Comparative Analysis of Clinical Characteristics and Outcomes between Carbapenem-Resistant and Carbapenem-Sensitive Klebsiella pneumoniae Infections: Insights from a Tertiary Hospital in Northern China

Provisionally accepted
Ning Song Ning Song 1*Bu Wang Bu Wang 1Zhang Wei Zhang Wei 2Hongxia Zhang Hongxia Zhang 2Maochen Li Maochen Li 2Xiulong Zhang Xiulong Zhang 2Xiaocui Peng Xiaocui Peng 2Na Wang Na Wang 2
  • 1 Department of Infectious Diseases, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
  • 2 First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei Province, China

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

    Background: To compare the risk factors, clinical outcomes, and mortality rates between carbapenem-resistant Klebsiella pneumoniae (CRKP) and carbapenem-sensitive Klebsiella pneumoniae (CSKP) infections. Methods: A retrospective cohort study was conducted on patients with Klebsiella pneumoniae infections admitted to a tertiary hospital in Zhangjiakou, China. The research period is from January 2021 to December 2022. Data were analyzed using SPSS 24.0 and R. Univariate analysis identified potential risk factors for CRKP infections using appropriate statistical methods, followed by multivariable logistic regression to determine independent risk factors. Mortality rates between CRKP and CSKP groups were compared using chi-square tests, and survival curves were generated with the Kaplan-Meier method. Results: The study included 283 patients, with 104 (36.7%) infected by CRKP and 179 (63.3%) by CSKP. CRKP patients had significantly higher body temperature, white blood cell counts, and inflammatory markers, while showing lower diastolic blood pressure and oxygen saturation (p<0.05). CRKP infections were predominantly found in the ICU (49%) and mainly isolated from sputum (59%). Independent risk factors for CRKP included elevated C-reactive protein (OR=1.02) and solid tumors (OR=18.186). CRKP patients experienced longer hospital stays (25 days vs. 12 days for CSKP), longer ICU stays (13 days vs. 7 days), and higher 30-day mortality (23.1% vs. 17.9%, p=0.012). The deceased group had elevated procalcitonin and creatinine levels, longer prothrombin time, and a greater need for mechanical ventilation compared to survivors (p<0.05). Conclusion: Patients with CRKP infections had higher mortality rates and longer hospital stays than those with CSKP infections. Previous hospitalization, hospitalization in an ICU, and mechanical ventilation were independent risk factors for CRKP infection.

    Keywords: antibiotic 1, drug resistant bacteria 2, 30-day mortality 3, odds ratio 4, clinical outcomes 5

    Received: 20 Sep 2024; Accepted: 20 Jan 2025.

    Copyright: © 2025 Song, Wang, Wei, Zhang, Li, Zhang, Peng and Wang. 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: Ning Song, Department of Infectious Diseases, Second Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.