Evidence map›Paper›PMID 40604428›Full record

ArticleBMC microbiology2025

Risk factors and outcomes of antibiotic-resistant Klebsiella pneumoniae bloodstream infections in adult patients with acute leukemia.

Juan Wu, Zhiqiang Xie, Xueyu Li, Kaili Du, Zhongxian Liao, Yawei Shi, Munire Abudumaijiti, Jiadi Chen, Yingping Cao, Xinmiao Fu

Abstract read
In one paragraph

Article in BMC microbiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Juan Wu *College of Life Sciences, Fujian Normal University, Fuzhou City, 350117, PR China.
Zhiqiang Xie *Department of Laboratory Medicine, Fujian Medical University Union Hospital, Fuzhou City, 350001, PR China.
Xueyu Li *Department of Laboratory Medicine, Fujian Medical University Union Hospital, Fuzhou City, 350001, PR China.
Kaili DuDepartment of Laboratory Medicine, Fujian Medical University Union Hospital, Fuzhou City, 350001, PR China.
Zhongxian LiaoDepartment of Laboratory Medicine, Fujian Medical University Union Hospital, Fuzhou City, 350001, PR China.
Yawei ShiDepartment of Laboratory Medicine, Fujian Medical University Union Hospital, Fuzhou City, 350001, PR China.
Munire AbudumaijitiDepartment of Laboratory Medicine, Fujian Medical University Union Hospital, Fuzhou City, 350001, PR China.
Jiadi ChenDepartment of Laboratory Medicine, Fujian Medical University Union Hospital, Fuzhou City, 350001, PR China. chenjd2013xh@fjmu.edu.cn.
Yingping CaoDepartment of Laboratory Medicine, Fujian Medical University Union Hospital, Fuzhou City, 350001, PR China. caoyingping@aliyun.com.
Xinmiao FuCollege of Life Sciences, Fujian Normal University, Fuzhou City, 350117, PR China. xmfu@fjnu.edu.cn.

Funding

the Joint Funds for the Innovation of Science and Technology, Fujian Province 2020Y9096the Joint Funds for the Innovation of Science and Technology, Fujian Province 2023Y9199the Startup Fund for scientific research, Fujian Medical University 2020QH1093
6 · The paper itself

Abstract

backgroundBloodstream infections (BSIs) caused by Klebsiella pneumoniae (K. pneumoniae) are a serious risk for patients with acute leukemia (AL), especially in the context of the increasing global prevalence of antibiotic-resistant strains. This retrospective study aimed to explore the risk factors for and outcomes of BSIs caused by antibiotic-resistant K. pneumoniae strains among AL patients.

methodsThis retrospective cohort study included patients with AL who suffered from K. pneumoniae BSIs from January 2017 to March 2024. Multivariate cox proportional hazards regression models were constructed to identify independent predictors of mortality. A Kaplan-Meier curve was used to evaluate the clinical outcomes of AL patients.

resultsThe study included 122 AL patients with K. pneumoniae BSIs. Multivariate analysis revealed that the previous use of quinolone, cephalosporin or aminoglycoside was an independent risk factor for carbapenem-resistant (CR) K. pneumoniae BSIs. Similarly, previous use of carbapenem or cephalosporin and hospitalization duration were independent risk factors for extended-spectrum β-lactamase (ESBL)-producing K. pneumoniae BSIs. Furthermore, the previous use of corticosteroids could prevent the development of CR K. pneumoniae BSIs and ESBL-K. pneumoniae BSIs. Previous treatment with quinolones, cephalosporins, and aminoglycosides independently contributed to the risk of multidrug-resistant (MDR)-K. pneumoniae BSIs. The 30-day mortality rate among these AL patients was 23.77%. The 30-day mortality rates for AL patients with MDR-K. pneumoniae BSIs and non-MDR-K. pneumoniae BSIs were 42.5% and 13.79%, respectively. Similarly, the CR of K. pneumoniae and ESBL-producing K. pneumoniae also increased the 30-day mortality rate among AL patients with K. pneumoniae BSIs. Multivariate analysis revealed that MDR-K. pneumoniae BSIs and age ≥ 55 years were independent risk factors for 30-day mortality.

conclusionsPrevious antibiotic exposure is a key risk factor for the development of antibiotic-resistant K. pneumoniae BSIs among AL patients. MDR K. pneumoniae BSIs and age older than 55 years were independent risk factors for 30-day mortality among AL patients with K. pneumoniae BSIs.

Indexed as

Anti-Bacterial AgentsBacteremiaKlebsiella InfectionsKlebsiella pneumoniaeLeukemiaAdultAgedAged, 80 and overDrug Resistance, Multiple, BacterialFemaleHumansMaleMiddle AgedRetrospective StudiesRisk FactorsAnti-Bacterial Agents30-day mortalityAcute leukemiaAntibiotic-resistant strainBloodstream infectionsKlebsiella pneumoniae

Identifiers

PMID40604428
PMCPMC12219591

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.