Results: Of the 79 eligible patients, the 30-day mortality rate of patients with KP BSI was
30.4%. Multivariate analysis showed that host-associated factors (increased APACHE II
score and septic shock) were strongly associated with increased 30-day mortality. For the
pathogenic factors, carriage of iutA (OR, 1.46; 95% CI, 1.11–1.81, p = 0.002) or
Kvar_1549 (OR, 1.31; 95% CI, 1.02–1.69, p = 0.043) was an independent risk factor,
especially when accompanied by a multidrug-resistant phenotype. In addition, ST11-K64
hypervirulent carbapenem-resistant KP co-harbored acquired blaKPC-2 together with iutA
(76.5%, 13/17) and Kvar_1549 (100%, 17/17) genes. Comparative genomic analysis
showed that they were clustered together based on a phylogenetic tree, and more
virulence genes were observed in the group of ST11-K64 strains compared with ST11non-K64. The patients infected with ST11-K64 strains were associated with relatively high
mortality (47.2%, 7/17).
Conclusion: The carriage of iutA and Kvar_1549 was seen to be an independent mortality
risk factor in patients with KP BSI. The identiﬁcation of hypervirulent and carbapenemresistant KP strains associated with high mortality should prompt surveillance.
Keywords: Klebsiella pneumoniae, bloodstream infection (BSI), mortality, hypervirulent, carbapenem-resistant,
risk factors

Frontiers in Cellular and Infection Microbiology | www.frontiersin.org

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September 2021 | Volume 11 | Article 688989

Wu et al.
Risks of Mortality in K. pneumoniae

was an independent predictor associated with increased 30-day
mortality in patients with KP BSIs (Namikawa et al., 2019).
Notably, the virulence genes detected in previous studies were
assessed by PCR, which may not fully address the clinically
important genes inﬂuencing KP pathogenicity and virulence.
The increasing availability of bacterial whole-genome sequencing
(WGS) allows for the practical identiﬁcation of virulence
factors in bacteria, including K. pneumoniae (Holt et al., 2015).

### Language ###
English

### Assessment ###
The mortality rate of patients with Klebsiella pneumoniae bloodstream infection could be a key statistic to extract.

### Query ###
Tell me the death rate within 30 days for people having Klebsiella pneumoniae in their blood.
Tell me the death rate within 30 days for people having Klebsiella pneumoniae in their blood.