肺炎克雷伯菌引起的感染很常见，死亡率很高。体外研究证明了头孢哌酮/舒巴坦 (CPZ/SUL) 对抗肺炎克雷伯菌的效力。然而，CPZ/SUL 治疗肺炎克雷伯菌菌血症的临床疗效尚未研究。本研究旨在将菌血症患者的临床结果与 CPZ/SUL 对肺炎克雷伯菌菌血症的最低抑菌浓度 (MIC) 联系起来。肺炎克雷伯菌分离株。这项多中心回顾性研究于 2017 年 7 月至 2021 年 4 月在台湾进行。本研究纳入了接受 CPZ/SUL 治疗的肺炎克雷伯菌菌血症患者。使用琼脂稀释法测定 CPZ/SUL MIC。收集并分析患者临床结果和特征的数据。总共纳入 201 名患者。在致病性肺炎克雷伯菌分离株中，180 株（89.5%）对 CPZ/SUL 敏感。大多数患者（n = 156，77.6%）都有良好的结果。 30天死亡率为11.9%（n = 24）。多变量风险分析显示，APACHE II 评分较高（优势比 [OR]，1.14；置信区间 [CI]，1.07-1.21；p < 0.001），转移性肿瘤（OR，5.76；CI，2.31-14.40；p < 0.001）和致病性肺炎克雷伯菌 CPZ/SUL MIC > 16 µg/ml（OR，4.30；CI，1.50-12.27；p = 0.006）与不良结果独立相关。肺炎克雷伯菌菌血症患者接受 CPZ/SUL 治疗当 CPZ/SUL MIC ≤ 16 µg/ml 时，1:1 的比例具有良好的结果。 APACHE II 评分较高和转移性肿瘤的患者预后不良。© 2024。作者。

Infections caused by Klebsiella pneumoniae are common and result in high mortality rates. In vitro studies demonstrated the potency of cefoperazone/sulbactam (CPZ/SUL) against Klebsiella pneumoniae. However, the clinical efficacy of CPZ/SUL for the treatment of K. pneumoniae bacteremia has not been studied.This study aimed to associate the clinical outcomes of patients with bacteremia with the minimal inhibitory concentrations (MICs) of CPZ/SUL against the causative K. pneumoniae isolates.This multicenter, retrospective study was conducted in Taiwan between July 2017 and April 2021. Patients with K. pneumoniae bacteremia treated with CPZ/SUL were enrolled in this study. CPZ/SUL MICs were determined using the agar dilution method. Data on the patients' clinical outcomes and characteristics were collected and analyzed.In total, 201 patients were enrolled. Among the causative K. pneumoniae isolates, 180 (89.5%) were susceptible to CPZ/SUL. Most patients (n = 156, 77.6%) had favorable outcomes. The 30-day mortality rate was 11.9% (n = 24). Multivariate risk analyses showed that higher APACHE II score (Odds Ratio [OR], 1.14; Confidence Interval [CI], 1.07-1.21; p < 0.001), metastatic tumors (OR, 5.76; CI, 2.31-14.40; p < 0.001), and causative K. pneumoniae CPZ/SUL MICs > 16 µg/ml (OR, 4.30; CI, 1.50-12.27; p = 0.006) were independently associated with unfavorable outcomes.Patients with K. pneumoniae bacteremia treated with CPZ/SUL at a ratio 1:1 had favorable outcomes when the CPZ/SUL MICs were ≤ 16 µg/ml. Patients with higher APACHE II scores and metastatic tumors had unfavorable outcomes.© 2024. The Author(s).