目的: 碳青霉烯耐药克雷伯菌感染（CR-KP）是一个重要的公共卫生问题。本研究旨在评估CR-KP患者的临床特征。方法: 对所有CR-KP感染的患者进行了一项回顾性队列研究。总共确定了615例CR-KP感染患者，并排除了不符合入选标准的135例患者。分析了临床特征、抗菌治疗方案和患者预后。结果: CR-KP感染的总体病死率为37.3%，而血流感染患者的病死率为66.2%。生存分析表明，血流感染患者与肺部和引流液感染患者之间存在显著差异。逻辑回归分析显示，血液系统疾病、年龄>60岁、实体肿瘤、糖尿病、感染性休克、急性肾损伤和中风是30天死亡率的独立预测因子。卡方检验显示，联合应用碳青霉烯类、替加环素和多粘菌素B的抗菌治疗方案优于仅应用碳青霉烯类和多粘菌素B的方案，不使用替加环素。结论: CR-KP感染，尤其是血流感染，具有较高的病死率。预后受患者临床状况的严重影响。联合使用碳青霉烯类、替加环素和多粘菌素B的抗菌治疗方案可能更好。

Purpose: Infections caused by carbapenem-resistant Klebsiella pneumoniae (CR-KP) are an important public health problem. This study aimed to evaluate the clinical characteristics of patients with CR-KP. Methods: A retrospective cohort study was conducted of all patients with CR-KP infection. A total of 615 patients with CR-KP infection were identified and 135 patients who did not meet the eligibility criteria were excluded. Clinical characteristics, antimicrobial regimens, and patient outcomes were analyzed. Results: The overall mortality rate of CR-KP infections was 37.3% and the mortality rate in patients with bloodstream infections was 66.2%. Survival analysis revealed that there were statistically significant differences between patients with bloodstream infections and those with pulmonary and drainage fluid infections. Logistics regression analysis showed that hemopathy, age >60 years, solid tumors, diabetes, septic shock, acute kidney injury, and stroke were independent predictors of 30-day mortality rate. The chi-square test showed that treatment with a combination of carbapenems, tigecycline, and polymyxin B was superior to treatment with carbapenems with polymyxin B, without tigecycline. Conclusions: CR-KP infections, especially bloodstream infections, have a high mortality rate. The outcome is strongly dependent on patients' clinical conditions. Antimicrobial regimens combining carbapenems, tigecycline, and polymyxin B might be a better choice.