ORIGINAL RESEARCH article
Front. Public Health
Sec. Infectious Diseases: Epidemiology and Prevention
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1668530
Clinical Epidemiology and Prognostic Factors in Patients with KPC-Producing K.pneumoniae Infections: A Retrospective Cohort Study
Provisionally accepted
- People's Liberation Army Joint Logistics Support Force 940th Hospital, Lanzhou, China
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Abstract Background This study aimed to investigate the clinical characteristics, drug resistance patterns, and prognosis of CRKP-infected patients. Methods This study evaluated in patients with carbapenemase-producing CRKP infection diagnosed through bacteriological evidence and clinical criteria over a 12-month period. Results KPC-producing Klebsiella pneumoniae represented 1.16% of all K. pneumoniae infections, the average patient age was 62.3±20.2 years. Lung infection (58%) was the most common site, followed by bloodstream infection (22%) and urinary tract (11%) infections; 86% were nosocomial. Common comorbidities included cerebrovascular disease/cerebral infarction (23%), lung disease (16%), hematologic diseases/malignancies (12%), and viral pneumonia (12%). KPC-Kp exhibited high resistance (>90%) to most tested antibiotics (including cephalosporins, piperacillin/tazobactam, fluoroquinolones, aztreonam, and carbapenems). Significantly lower resistance was observed only to tigecycline (5.1%) and ceftazidime-avibactam (CAZ-AVI) (4.3%). Non-KPC strains (NDM/VIM/OXA-48; n=48) showed lower resistance (<50%) to several agents and minimal resistance to tigecycline and CAZ-AVI (0-1.0%); resistance differences between KPC and non-KPC groups were highly significant (p<0.001).KPC-Kp infection conferred significantly higher in-hospital mortality (46%) than non-KPC infections (10.4%; p<0.001), with nearly half (48%) of KPC-Kp deaths occurring within 7 days of infection. CAZ-AVI usage within the KPC-Kp group did not significantly improve 28-day survival (0.450±0.132 vs 0.573±0.076, p=0.317). Multivariate analysis identified significant independent risk factors for in-hospital mortality: KPC-Kp infection (OR 5.96, p<0.001), bloodstream infection (OR 8.57, p=0.006), and ICU admission (OR 3.39, p=0.006). Conclusion KPC-Kp infections demonstrated high incidence (1.16%), and severe mortality (46% in-hospital). Mortality risk was significantly elevated by KPC-Kp infection, bloodstream infection, and ICU admission, underscoring critical clinical threats.
Keywords: KPC-Kp, Clinical Characteristics, survival analysis, Mortality, Risk factors
Received: 18 Jul 2025; Accepted: 03 Oct 2025.
Copyright: © 2025 Feng, Song, Xue and Ha. 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: Xiaoqin Ha, fqs328@163.com
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