TY - JOUR A2 - dos Santos, Washington L. C. AU - Song, Feizhen AU - Zhang, Kai AU - Huang, Jianjiang AU - Qian, Zhenhua AU - Zhou, Hongwei AU - Cai, Jiachang AU - Zheng, Cheng AU - Zhou, Feifei AU - Cui, Wei AU - Zhang, Gensheng PY - 2021 DA - 2021/06/19 TI - Clinical Characteristics, Risk Factors, and Outcomes of Patients with Polymicrobial Klebsiella pneumoniae Bloodstream Infections SP - 6619911 VL - 2021 AB - Background. Polymicrobial Klebsiella pneumoniae bloodstream infection (KP-BSI) has been reported to account for more than 10% of all KP-BSI, but few studies have characterized polymicrobial KP-BSI. Our study investigated the clinical characteristics, risk factors, and outcomes of polymicrobial KP-BSI by comparing with monomicrobial KP-BSI. Methods. We conducted a single-center retrospective cohort study of patients with KP-BSI from 1 January 2013 to 31 December 2018 and collected the clinical data by reviewing electronic medical records. Results. Of the 818 patients with KP-BSI recruited, 13.9% (114/818) were polymicrobial KP-BSI. The severity of illness in polymicrobial and monomicrobial KP-BSI was similar, while the rate of resistance to carbapenems was obviously higher in polymicrobial KP-BSI (78.1% vs. 65.6%, p=0.009). On multivariate analysis, hospitalization in burn ward (odds ratio (OR) 6.13, 95% confidence interval (CI) 2.00-18.76, p=0.001) and intensive care unit (OR 2.39, 95% CI 1.05-5.43, p=0.038) was independently associated with polymicrobial KP-BSI. Gram-negative bacteria accounted for the highest proportion (68.9%) among copathogens of polymicrobial KP-BSI, whereas gram-positive bacteria (22.9%) and Candida (8.2%) ranked the second and the third, respectively, with Acinetobacter baumannii being the most common (23.0%). Patients with polymicrobial KP-BSI had longer hospital days after BSI onset and total hospital days than patients with monomicrobial KP-BSI (median (interquartile range (IQR)), 19 (5, 39) vs. 12 (6, 25), 37 (21, 67) vs. 29 (16, 53), respectively, p<0.05). The mortality did not differ between polymicrobial KP-BSI and monomicrobial KP-BSI (all p>0.05). Conclusions. It was observed that polymicrobial KP-BSI accounted for a significant proportion among all KP-BSI in the current study. Hospitalization in burn ward and intensive care unit was an independent risk factor for the development of polymicrobial KP-BSI. The patients with polymicrobial KP-BSI had a higher rate of carbapenem-resistant K. pneumoniae and might have poor outcomes compared to monomicrobial KP-BSI. SN - 2314-6133 UR - https://doi.org/10.1155/2021/6619911 DO - 10.1155/2021/6619911 JF - BioMed Research International PB - Hindawi KW - ER -