ZUHAL KALAYCI ÇEKİN, MUSTAFA DENİZ
Northwestern Medical Journal - 2025;5(3):177-185
Aim: In recent years, Klebsiella pneumoniae bloodstream infections (KP-BSIs) have emerged as a major public health concern due to their increasing prevalence and their strong association with high morbidity and mortality rates. Despite this growing threat, there is a lack of epidemiological data specific to Bolu province, Turkey. This study aims to characterize the epidemiological, microbiological, and clinical features of KP-BSIs in this region, with a particular focus on identifying risk factors associated with carbapenem resistance and patient mortality. METHODS: A total of 142 patients with KP-BSIs that developed in the intensive care unit (ICU) over approximately four years were included in the study. The association between demographic and clinical data of the patients and carbapenem resistance and mortality was analyzed. Results: Among the patients monitored in the intensive care unit, 64.8% died. No independent predictors were identified for the development of carbapenem-resistant K. pneumoniae infections in the multivariate analysis. However, the following factors were found to be associated with an increased risk of mortality: age over 65 years, the presence of pneumonia or a urinary tract infection a bloodstream infection linked to an intravenous catheter, prior use of a central venous catheter, hospitalisation within the last three months, recent or prolonged exposure to broad-spectrum antibiotics, and infections at other anatomical sites. Notably, having a tracheostomy was associated with a reduced risk of death, while a one-unit increase in albumin was associated with a 13.8% lower risk of death, a one-unit increase in C-reactive protein (CRP) was associated with a 1.9% higher risk. Conclusions: This study provides important data on the rate of KP-BSI isolated from secondary care facilities and the risk factors for mortality. Existing literature has typically focused on identifying risk factors for death in tertiary care public hospitals. However, this study examined the intensive care units of secondary care public hospitals and found high mortality rates among patients. The high mortality rate of patients with KP-BSI highlights the urgency of implementing appropriate infection control strategies
