Epidemiological investigation of burn patients with Klebsiella pneumoniae infection and the analysis of risk factors for sepsis in them

Abstract

Objective: To analyze the prevalence trend of Klebsiella pneumoniae (KP) infection in the Department of Burns of the Second Affiliated Hospital of Zhejiang University School of Medicine (hereinafter referred to as the author's department) from 2015 to 2017, and to screen out the independent risk factors for sepsis in burn patients with KP infection. Methods: The clinical and bacteriological data of burn patients with KP infection from January 1, 2015 to December 31, 2017 were collected from the author's department. The variation trend in infection rates of KP and carbapenems-resistant KP (CRKP) during the three years were statistically analyzed, and the data were processed with chi-square test. Clinical data were processed with binary logistic regression analysis to screen out the independent risk factors for sepsis in burn patients with KP infection. Results: (1) From 2015 to 2017, 91 patients (50 males and 41 females, aged 15-90 years) with KP infection were diagnosed in the author's department, of which 65 cases were CRKP positive, and 26 cases were carbapenems-sensitive KP positive. The KP infection rates of patients in 2015, 2016, and 2017 were 5.79% (35/605), 4.08% (23/564), and 5.54% (33/596), respectively. The CRKP infection rates of patients in 2015, 2016, and 2017 were 3.31% (20/605), 3.37% (19/564), and 4.36% (26/596), respectively. There were no statistically significant differences in KP infection rate and CRKP infection rate of patients among the three years (χ(2)=2.007, 1.175, P>0.05). (2) Total burn area and CRKP infection were independent risk factors for sepsis in burn patients with KP infection (odds ratios=1.03, 5.88, 95% confidence intervals=1.01-1.05, 1.08-31.94, P<0.05). Conclusions: From 2015 to 2017, the infection rates of KP and CRKP in the author's department did not increase obviously, but the proportion of CRKP infection was high. CRKP infection is one of the independent risk factors for sepsis in burn patients with KP infection. Strengthening the prevention and treatment of CRKP infection may have certain value in decreasing the incidence of burn sepsis.