未经证实:中性粒细胞与淋巴细胞之比(NLR)是炎症的有用标记。然而,NLR在碳青霉烯类耐药肺炎克雷伯菌(CRKP)血流感染(BSI)患者中的预后功能尚不清楚.这项研究的目的是探讨NLR与这些患者死亡率之间的潜在关系。
UNASSIGNED:我们从2017年1月1日至10月31日,根据从三级医院的计算机化患者记录系统检索到的数据进行了一项回顾性队列研究。2020年。本研究共纳入134例CRKPBSI住院患者,包括54例死亡病例和80例存活病例,CRKPBSI发病后28天。进行逻辑分析以评估第4天NLR和28天死亡率之间的关联。多因素分析用于控制混杂因素。
UNASSIGNED:CRKPBSI发作患者的28天总死亡率为40.3%(54/134)。我们对134例患者的数据进行了多变量分析,发现第4天的NLR[优势比(OR)1.148,95%置信区间(CI)1.076-1.225,p<0.001]和BSI发病前的抗生素暴露(OR3.847,95%CI1.322-11.196,p=0.013)是KCRPBSI患者28天死亡率的独立危险因素,而适当的初始治疗(AIT,OR0.073,95%CI0.017-0.307,p<0.001)是独立的保护因素。在接受AIT治疗的患者中,Cox比例风险回归分析显示,头孢他啶/阿维巴坦(CAZ)组和非CAZ-AVI组之间的预后存在显著差异(p=0.006).将非CAZ-AVI组分为替加环素(TGC)后,粘菌素(COL),和TGC+COL组,CAZ-AVI组和TGC组之间没有差异(p=0.093),但CAZ-AVI组28天死亡率低于COL(p=0.002)和TGC+COL(p=0.002)组。同时,不同组患者第1天的NLR无差异(p=0.958),但第4天的NLR有显著差异(p=0.047)。
未经证实:第4天的NLR是CRKPBSI患者的一种现成的独立预后生物标志物。该标记物可能具有用于在早期阶段评估不同抗感染治疗策略的功效的潜力。
UNASSIGNED: The neutrophil-to-lymphocyte ratio (NLR) is a useful marker of inflammation. However, the prognostic function of the NLR in patients with carbapenem-resistant Klebsiella pneumoniae (CRKP) blood stream infection (BSI) remains largely unknown. The aim of this study was to explore the potential relationship between the NLR and mortality in these patients.
UNASSIGNED: We performed a retrospective cohort study based on data retrieved from the computerized patient record system in a tertiary hospital from 1 January 2017 to 31 October, 2020. A total of 134 inpatients with CRKP BSI were enrolled in this study, including 54 fatal cases and 80 survival cases, 28 days after the onset of CRKP BSI. A logistic analysis was performed to assess the association between the NLR on the 4th day and 28-day mortality. Multivariate analyses were used to control for the confounders.
UNASSIGNED: The overall 28-day mortality rate of patients with a CRKP BSI episode was 40.3% (54/134). We conducted a multivariate analysis of the data of 134 patients and found that the NLR on the 4th day [odds ratio (OR) 1.148, 95% confidence interval (CI) 1.076-1.225, p < 0.001] and antibiotic exposure before BSI onset (OR 3.847, 95% CI 1.322-11.196, p = 0.013) were independent risk factors for 28-day mortality of patients with CRKP BSI, while appropriate initial therapy (AIT, OR 0.073, 95% CI 0.017-0.307, p < 0.001) was an independent protective factor. Among patients treated with AITs, the Cox proportional hazards regression analysis revealed a significant difference in prognosis (p = 0.006) between the ceftazidime/avibactam contained (CAZ) group and non CAZ-AVI groups. After dividing the non CAZ-AVI group into the tigecycline (TGC), colistin (COL), and TGC + COL groups, there were no differences between the CAZ-AVI group and the TGC group (p = 0.093), but CAZ-AVI group showed lower 28-day mortality than COL (p = 0.002) and TGC + COL (p = 0.002) groups. Meanwhile, there was no difference in NLR on the 1st day (p = 0.958) of patients in different groups but significant difference in NLR on the 4th day (p = 0.047).
UNASSIGNED: The NLR on the 4th day is a readily available and independent prognostic biomarker for patients with CRKP BSI. This marker may have the potential for use in evaluating the efficacy of different anti-infection therapy strategies at an early stage.