Epidemic, risk factors of carbapenem-resistant Klebsiella pneumoniae infection and its effect on the early prognosis of liver transplantation

Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) infection remains a major cause of morbidity and mortality in early-stage post-liver transplantation (LT). Methods: We retrospectively analyzed the demographic and clinical infections characteristics of all LT recipients in our hospital between January 2019 and December 2021. Results: Among the 272 LT recipients who received LT between January 2019 and December 2021, sixty-two patients had at least one infection within 3-months post-LT, with a prevalence of 22.8% (62/272). The prevalence of CRKP infections was 7.0% (19/272), and the 3-months post-LT mortality was 19.4% (12/62). The risk factors independently related to 3-months mortality were age (Odds ratio (OR)= 1.126, 95% Confidence interval (CI): 1.009 similar to 1.257; P=0.034), mechanical ventilation (MV) (OR=1.206, 95% CI: 1.039 similar to 1.401; P =0.014), and CRKP infection (OR=18.240, 95% CI: 2.206 similar to 450.842; P =0.007). In CRKP infection, the length of ICU stay (OR=1.067, 95% CI: 1.015 similar to 1.122; P=0.011), pre-operation infection (P01) (OR=6.733, 95% CI: 1.160 similar to 39.088; P=0.034), and hepatocellular carcinoma (HCC) (OR=26.772, 95% CI: 1.747 similar to 410.187; P=0.018) were the independent risk factors. With COX multivariate regression analysis, the 3-months survival rate of CRKP infected patients was significantly lower than that without CRKP infection post-LT. Conclusions: CRKP infection is closely correlated with poor prognosis in 3-months post-LT.

Automated summary

This study retrospectively analyzed the infection characteristics and related factors of liver transplant recipients in our hospital and found a significant correlation between CRKP infection and mortality in the early stage post-liver transplantation.