Background: Klebsiella pneumoniae bloodstream infection (KP-BSI) represents a global clinical threat, while local prognostic data are scarce in Hebei Province, China. This study aimed to identify risk factors for carbapenem-resistant Klebsiella pneumoniae (CRKP) infection and in-hospital mortality in KP-BSI patients. Methods: A retrospective observational audit was conducted at a provincial tertiary hospital. Adult non-repeat KP-BSI episodes (2022–2025) were divided into CRKP (n = 156) and carbapenem-susceptible Klebsiella pneumoniae (CSKP, n = 357), as well as survivor and non-survivor subgroups. Clinical, laboratory and microbiological data were extracted from electronic medical records. Univariate and multivariate logistic regression analyses were performed. Results: Among 513 KP-BSI cases, CRKP detection rate was 30.4% and the overall in-hospital mortality was 25.0%. CRKP isolates showed extensive multidrug resistance, with low resistance to colistin (3.5%) and tigecycline (49.0%). Advanced age (per 10-year increment), male sex, invasive procedures, empirical antimicrobial therapy and pre-existing respiratory disease were independent risk factors for CRKP infection. quick Pitt bacteremia score (qPitt score) ≥ 2 and intensive care unit (ICU) admission independently predicted in-hospital mortality; CRKP bacteremia was not an independent mortality predictor after confounder adjustment. Multisite KP isolation occurred in 44.4% of patients, most frequently from the respiratory tract. Conclusions: CRKP-BSI imposes a considerable resistance burden. Infection control should target high-risk patients: elderly males with respiratory comorbidities undergoing invasive procedures. Mortality depends on disease severity (qPitt score, ICU admission), not carbapenem-resistance status. qPitt-based risk stratification and antimicrobial stewardship are essential to improve patient outcomes.

Background: Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease in which anti-double-stranded DNA (anti-dsDNA) antibodies are closely associated with disease activity and organ involvement. However, the relationships of 25-hydroxyvitamin D [25(OH)D], CD4 ⁺ /CD8 ⁺ ratio, and prognostic nutritional index (PNI) with anti-dsDNA antibody status and titer stratification remain incompletely understood. Methods: A total of 126 patients with SLE were enrolled and classified into an anti-dsDNA-negative group and an anti-dsDNA-positive group. According to anti-dsDNA titers, patients were further stratified into low-titer and high-titer groups. Clinical characteristics and laboratory parameters, including 25(OH)D, CD4 ⁺ /CD8 ⁺ ratio, and PNI, were compared among groups. Receiver operating characteristic curve analysis was performed to evaluate the discriminatory performance of 25(OH)D, CD4 ⁺ /CD8 ⁺ ratio, PNI, and their combined model. Results: Compared with anti-dsDNA-negative patients, anti-dsDNA-positive patients had significantly lower levels of C3, C4, the CD4 ⁺ /CD8 ⁺ ratio, 25(OH)D, and PNI, together with a higher prevalence of renal involvement (all P < 0.05). Significant differences in 25(OH)D, the CD4 ⁺ /CD8 ⁺ ratio, and PNI were also observed across the anti-dsDNA-negative, low-positive, and high-positive groups. In ROC analysis, 25(OH)D showed the highest AUC among the individual biomarkers for anti-dsDNA serostatus, whereas the combined assessment achieved the highest overall AUC. For stratifying low-positive from high-positive anti-dsDNA titers, the combined assessment showed better discriminatory performance than PNI and C3. Conclusions: Combined assessment of 25(OH)D, the CD4 ⁺ /CD8 ⁺ ratio, and PNI may provide complementary value for anti-dsDNA-based stratification in SLE. Its performance was comparable to C3 for anti-dsDNA serostatus and superior to C3 for stratifying low-from high-positive anti-dsDNA titers. These findings should be considered exploratory and require validation in external cohorts.

Objective: This study analyzes the value of serum Gasdermin D (GSDMD) as a novel biomarker for the early diagnosis and disease progression of heart failure. Methods: We conducted a retrospective analysis of clinical data and laboratory results to compare the GSDMD levels among the heart failure group, other cardiac disease group, and healthy control group. We investigates the correlation between GD and other indicators, as well as the independent risk factors for heart failure. Receiver operating characteristic (ROC) curve analysis was conducted to compare the diagnostic value of serum GSDMD, N-terminal pro-B-type natriuretic peptide (NT-ProBNP), ejection fraction (EF) in patients. Results: There were statistically significant differences in serum GSDMD, EF and other laboratory tests among the three groups (P< 0.05). Among heart failure patients with different cardiac function classifications, the serum levels of NT-ProBNP, GSDMD increased with the increase in cardiac function classification. Serum GSDMD was correlated with all indicators (P< 0.05) in subjects. Serum GSDMD and NT-ProBNP were independent risk factors while EF was an independent protective factor for heart failure. The AUCs of serum GSDMD, NT ProBNP, and EF for diagnosing heart failure were 0.819, 0.970, and 0.831, respectively, while the AUC of their combined diagnosis of heart failure was 0.986. Conclusion: This study suggests that Serum GSDMD, as a novel sensitive biomarker, has the potential for early diagnosis and disease progression assessment of heart failure.