Investigating risk factors and antibiotic resistance of bloodstream infections causing Klebsiella pneumoniae in burn patients

This study aimed to investigate the risk factors associated with bloodstream infections (BSI) caused by Klebsiella pneumoniae (KP) and the antibiotic resistance of KP in patients with severe burns. This retrospective study included severe burn patients admitted to the Author's Hospital. KP-induced BSI was confirmed by blood culture. The patients with confirmed KP-infection were placed in the KP-infection group and the remaining patients were included in the noninfection group. A total of 113 patients were included in the study, with 65 males. Among them, 23 patients were classified into the KP-infection group, and 90 patients were classified into the noninfection group. The multivariate logistic regression analysis found that total burn area (OR = 2.674; 95% CI: 1.265-7.164, P = .034), concurrent inhalation injury (OR = 3.295; 95% CI: 1.165-6.265, P = .026), third-degree burn area (OR = 2.834; 95% CI: 1.155-6.954, P = .012), and catheter indwelling time (OR = 3.169; 95% CI: 1.281-7.838, P = .009) were the independent risk factors for KP-dominated BSI in burn patients. All 23 KP strains from blood cultures were 100% resistant to ciprofloxacin, cefazolin, and piperacillin/tazobactam, 75.22% resistant to amikacin, 66.32% to cefoperazone/sulbactam, 60.87% to imipenem/cilastatin, and 60.87% to meropenem, while showing low resistance to tigecycline (4.35%) and polymyxin B (0.00%). Total burn area, concurrent inhalation injury, third-degree burn area, and catheter indwelling time were significant risk factors for BSI caused by KP in patients with severe burns. KP strains were highly resistant to multiple antibiotics, necessitating careful selection of susceptible antibiotics based on their resistance profiles.