Zhongguo linchuang yanjiu (Nov 2023)
Clinical distribution and drug resistance analysis of 3 342 strains of Klebsiella pneumoniae from 2018 to 2022
Abstract
Objective To analyze the clinical distribution of Klebsiella pneumoniae isolates, screen for the multidrug resistance of Klebsiella pneumoniae strains to commonly used antimicrobial drugs, and provide reference for the prevention and control of hospital-acquired infections and rational clinical use of antimicrobial drugs. Methods Various clinical specimens collected from January 2018 to December 2022 at the Zhongda Hospital Affiliated to Southeast University were cultured to isolate bacteria. The VITEK automated microbial analyzer was used to identify the bacterial species. A total of 3 342 non-repetitive Klebsiella pneumoniae isolates were obtained during this period. Each Klebsiella pneumoniae strain was subjected to drug susceptibility testing using automated antimicrobial systems, disk diffusion methods, or standard broth microdilution methods to determine the antibiotic resistance profiles of Klebsiella pneumoniae. The detection rate of Klebsiella pneumoniae in clinical specimens and its association with specimen sources or department categories were analyzed. Results Klebsiella pneumoniae isolates were obtained from sputum (42.07%), urine (14.81%), and blood (10.29%). The departments with higher detection rates of Klebsiella pneumoniae were Intensive Care Unit (ICU) (35.19%), Neurosurgery (6.28%), and Respiratory and Critical Care Medicine (5.42%). The resistance identification results showed the highest resistance rate to ampicillin (100.00%) and the lowest resistance rate to amikacin (4.22%). Annual analysis of resistance rates to carbapenems in Klebsiella pneumoniae isolates from 2018 to 2021 revealed an increasing trend: 2.94%, 4.66%, 7.90%, and 15.35%, respectively. However, in 2022, the resistance rate started to decrease (5.38%). Carbapenem-resistant Klebsiella pneumoniae strains were predominantly of the KPC type, and there was a statistically significant difference in the resistance rates to commonly used antimicrobial drugs between carbapenem-resistant Klebsiella pneumoniae and carbapenem-sensitive Klebsiella pneumoniae(P＜0.01). Conclusion Klebsiella pneumoniae maintains a high level of clinical isolation rate, along with high resistance rates. Therefore, it is necessary to strengthen the prevention and control of hospital-acquired bacterial infections and surveillance of drug resistance. Rational selection of antimicrobial drugs should be employed for the treatment of Klebsiella pneumoniae infections.
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