Clinical characteristics and risk factors associated with secondary bloodstream infection in patients with intensive care unit-acquired pneumonia due to carbapenem-resistant Klebsiella pneumoniae

The global spread of carbapenem-resistant Klebsiella pneumoniae(CRKP)has become a major healthcare burden because of the limited therapeutic options and poor prognosis,and this situation gets worse among patients admitted to intensive care unit(ICU).[1]CRKP can cause a range of infections,including pneumonia,urinary tract infection(UTI),and bloodstream infection(BSI).BSI is one of the most serious infections caused by CRKP and associated with high mortality ranging from 39%to 82%.[2]BSI due to CRKP could be primary infection or secondary infection that originated from primary infections in the lungs or bladder,and 50%of CRKP-BSIs originated from primary infections in the lungs.[3]Although previous studies have explored several risk factors for CRKP infections,the association between CRKP pneumonia and the development of secondary CRKP-BSI was not fully revealed thus far.The aim of this study was to predict risk factors of 28-day mortality and the development of secondary CRKP-BSI in ICU-acquired pneumonia caused by CRKP.