Risk factors and clinical characteristics of bloodstream infection caused by ESBL-producing Klebsiella pneumoniae

Panpan Xu; Qingqing Chen; Yifeng Mao; Xijiang Zhang; Qin Si; Cheng Zheng

doi:10.3855/jidc.22258

Risk factors and clinical characteristics of bloodstream infection caused by ESBL-producing Klebsiella pneumoniae

Authors

Panpan Xu Department of Critical Care Medicine, Taizhou Municipal Hospital (Taizhou University Affiliated Municipal Hospital), School of Medicine, Taizhou University, Taizhou, Zhejiang 318000, China
Qingqing Chen Rehabilitation Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang 318000, China
Yifeng Mao Department of Critical Care Medicine, Taizhou Municipal Hospital (Taizhou University Affiliated Municipal Hospital), School of Medicine, Taizhou University, Taizhou, Zhejiang 318000, China
Xijiang Zhang Department of Critical Care Medicine, Taizhou Municipal Hospital (Taizhou University Affiliated Municipal Hospital), School of Medicine, Taizhou University, Taizhou, Zhejiang 318000, China
Qin Si Department of Critical Care Medicine, Taizhou Municipal Hospital (Taizhou University Affiliated Municipal Hospital), School of Medicine, Taizhou University, Taizhou, Zhejiang 318000, China
Cheng Zheng Department of Critical Care Medicine, Taizhou Municipal Hospital (Taizhou University Affiliated Municipal Hospital), School of Medicine, Taizhou University, Taizhou, Zhejiang 318000, China

DOI:

https://doi.org/10.3855/jidc.22258

Keywords:

ESBL, Klebsiella pneumoniae, bacteremia, phenotype, determinants

Abstract

Introduction: The aim of this study was to analyze the clinical characteristics and risk factors of bloodstream infections (BSI) caused by extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae (KP).

Methodology: A retrospective study was conducted by enrolling clinically confirmed KP-BSI cases (2019–2023). Clinical data were collected and analyzed through review of the electronic medical records. Patients with ESBL-positive KP-BSI were compared to those with ESBL-negative KP-BSI. Multivariate logistic regression analysis was used to identify risk factors associated with ESBL-producing KP-BSI.

Results: A total of 199 patients were included, among whom 47 (23.6%) had ESBL-producing KP-BSI. Univariate analysis revealed that the proportion of patients undergoing surgery within 48 hours before blood sampling was higher in the ESBL-positive group than in the ESBL-negative group (40.4% vs. 23.0%, p < 0.05). Regarding infection source, liver-origin infections were less frequent in the ESBL-positive group compared to the ESBL-negative group (6.4% vs. 24.3%, p < 0.05), while urinary tract-origin infections were significantly more frequent in the ESBL-positive group (38.3% vs. 18.4%, p < 0.05). Hospital-acquired infection was more common in the ESBL-positive group than in the ESBL-negative group (40.4% vs. 23.7%, p < 0.05). Multivariate analysis identified urinary tract origin (adjusted odds ratio [aOR], 2.162; 95% confidence interval [CI], 1.003–4.661) as an independent risk factor for ESBL-producing KP-BSI.

Conclusions: Primary urinary tract infections constitute an independent risk factor for ESBL-producing KP-BSI. Given the therapeutic complexity of ESBL-producing strains, KP-BSI of urinary tract origin warrant heightened clinical vigilance among clinicians.

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Published

2026-07-31

How to Cite

Xu P, Chen Q, Mao Y, Zhang X, Si Q, Zheng C (2026) Risk factors and clinical characteristics of bloodstream infection caused by ESBL-producing Klebsiella pneumoniae. J Infect Dev Ctries 20:1021–1030. doi: 10.3855/jidc.22258

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Issue

Vol. 20 No. 07: July 2026

Section

Original Articles

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