A Retrospective Analysis of Polymyxin B Combined with Tigecycline in the Treatment of Multi-Drug Resistance Klebsiella pneumoniae Infection: Hypertension Increases the Incidence of Acute Kidney Injury

Multidrug resistance Klebsiella pneumoniae infection is an essential factor threatening the life of patients with severe infection. Polymyxin B is widely used in treating multidrug resistance Klebsiella pneumoniae, but few studies on its efficacy and safety. In our study, 205 patients with multidrug resistance Klebsiella pneumoniae infection were admitted to our hospital from January 2017 to December 2020, treated with polymyxin B for antibacterial and selected as the subjects. These patients were divided into two therapy groups: A monotherapy group (polymyxin B) and a combined therapy group (polymyxin B-tigecycline). The efficacy and safety of the two groups were analyzed. Also, the risk factors were analyzed. The changes of cystatin C, beta 2-microglobulin and microalbuminuria in the two groups showed an upward trend during the treatment. The descent degree of procalcitonin, C-reaction protein and white blood cell count in the polymyxin B-tigecycline group was higher than that in the polymyxin B group. The two groups had a similar effective rate, while acute kidney injury incidence in the polymyxin B-tigecycline group was higher than in the polymyxin B group. Blood infection, hypertension, high dose of tigecycline were risk factors for acute kidney injury. It was the first time to report that hypertension is an independent risk factor of acute kidney injury when polymyxin B combined with tigecycline is used to treat multidrug resistance Klebsiella pneumoniae infection. Patients with hypertension infected with multidrug resistance Klebsiella pneumonia should avoid accepting the combination therapy of polymyxin B and tigecycline.