这项工作的目的是评估与肺炎克雷伯菌 (Kpn) 引起的血流感染 (BSI) 相关的动态细胞因子谱，并调查与死亡率相关的临床特征。共有 114 名 BSI-Kpn 阳性患者和 12 名无血液脓毒症患者随访细菌培养呈阳性。诊断后第一天、第三天、第七天和第十四天通过多重免疫分析分析细胞因子谱。测试细胞因子包括精氨酸酶、干扰素-γ (IFN-γ)、肿瘤坏死因子α (TNF-α)、白细胞介素(IL)-1β、IL-4、IL-6、IL-10、IL-12 (p70)和IL-23。对 24 种抗生素的 BSI-Kpn 进行了最低抑菌浓度 (MIC) 测试。使用逻辑分析和列线图评估与 30 天死亡率和 120 天死亡率相关的危险因素。114 名 BSI-Kpn 患者中有 55 名被纳入。所有分离株均对新型阿维巴坦组合表现出高敏感性。碳青霉烯类耐药 Kpn (CRKP) 患者的精氨酸酶水平最高。精氨酸酶、TNF-α和IL-4的AUC分别达到0.726、0.495和0.549，而这三种细胞因子组合的AUC为0.805。值得注意的是，CRKP 患者的 120 天死亡率高于碳青霉烯类敏感肺炎克雷伯菌 (CSKP)。此外，长期高水平的IL-6和IL-10与死亡相关。精氨酸酶的高表达与CRKP相关。此外，BSI-CRKP可导致惰性临床过程，但长期预后不良。 IL-6 和 IL-10 的持续增加与死亡率相关。© 2024。作者。

The aim of this work was to assess dynamic cytokine profiles associated with bloodstream infection (BSI) caused by Klebsiella pneumoniae (Kpn) and investigate the clinical features associated with mortality.A total of 114 patients with positive BSI-Kpn and 12 sepsis individuals without blood positive bacteria culture were followed up. Cytokine profiles were analyzed by multiplex immunoassay on the first, third, seventh and fourteenth day after diagnosis. The test cytokines included arginase, interferon-gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), interleukin (IL)-1β, IL-4, IL-6, IL-10, IL-12 (p70), and IL-23. The minimum inhibitory concentration (MIC) of 24 antibiotics were tested for BSI-Kpn. Risk factors associated with the 30-day mortality and 120-day mortality were evaluated using logistic analyses and nomogram.There were 55 out of 114 patients with BSI-Kpn were included. All isolates showed high susceptibility rate to novel avibactam combinations. The level of arginase was the highest in carbapenem-resistant Kpn (CRKP) patients. The AUCs of arginase, TNF-α and IL-4 reached 0.726, 0.495, and 0.549, respectively, whereas the AUC for the combination of these three cytokines was 0.805. Notably, 120-day mortality in patients with CRKP was higher than carbapenem-sensitive K. pneumoniae (CSKP). Furthermore, the long-term and high levels of IL-6 and IL-10 were associated with death.High expression of arginase is correlated with CRKP. In addition, BSI-CRKP could result in indolent clinic course but poor long-term prognosis. Continuous increase of IL-6 and IL-10 were associated with mortality.© 2024. The Author(s).