Retrospective analysis on changes in clinical distribution and antimicrobial resistance of 2,426 strains of Klebsiella pneumonia, 2017-2020
LIU Qing-yu1, WANG Hong-zhang2, JIANG Si-yu1, KUANG Min1, DENG Lan-ping1, TAN Ling-hui1, ZHU Hui-bin1, NING Xing-wang1
1. The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha, Hunan 410007, China; 2. Changsha Medical University, Changsha, Hunan 410219, China
Abstract：Objective To understand the clinical distribution and drug resistance characteristics of Klebsiella pneumoniae (KP) in the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine, to analyze the changes in drug resistance of carbapenem-resistant Klebsiella pneumoniae (CRKP), and to provide a basis for rational selection of antimicrobial drugs in clinical practice. Methods We retrospectively analyze the specimen source, department source, and overall drug susceptibility testresults of the clinically isolated KP from January 2017 to December 2020. The separation rate of CRKP from sources in different years and major departments and the changes in resistance of antibacterial drugs commonly used were statistically analyzed. Results A total of 2,426 non-repetitive KP strains were isolated from 2017 to 2020, of which 1,825 (75.23%) were from the lower respiratory tract, 246 (10.14%) from urine, and 164 (6.76%) from whole blood. Department of respiratory medicine, department of geriatrics and central ICU ranked the top three departments from which the strains were isolated, with a total of 924 isolates (38.09%). The drug resistance rates of all isolates to ceftriaxone, imipenem, amikacin and tigecycline were 34.36%, 20.02%, 7.79% and 2.31% respectively. A total of 500 strains of CRKP were isolated. The separation rates of CRKP for 4 years in 2017-2020 were 23.34%, 25.30%, 18.52%, and 13.94% respectively. The separation rates of CRKP isolated from central ICU anddepartment of burn, trauma and plastic surgery were as high as 61.82% and 59.26%, respectively. The resistance rates of CRKP toamikacin for 4 years in 2017-2020 were 49.64%, 30.36%, 31.75%, and 23.19%, respectively, and those to tigecycline were 7.30%, 7.74%, 6.35% and 8.70%, respectively. CRKP was highly resistant to other commonly-used antimicrobial agents. Conclusion KP isolated clinically in the hospital mainly came from the elderly and severe patients with infections of respiratory tract, urinary tract and blood, and the drug resistance was relatively severe. The separation rates of CRKP in 2019 and 2020 showed a downward trend, which needs further observation. It is necessary to pay special attention to the clinical application ofcombined therapy for CRKP infection. Department of nosocomial infection should enhance the regulation of multi-drug resistant KP and antibacterial drugs, prevent hospital-acquired infections, and pay special attention to CRKP nosocimial transmission.
刘青宇, 王宏张, 姜思宇, 匡敏, 邓兰平, 谭凌卉, 朱惠斌, 宁兴旺. 2017—2020年2 426株肺炎克雷伯菌临床分布及耐药性变迁回顾性分析[J]. 实用预防医学, 2022, 29(1): 42-45.
LIU Qing-yu, WANG Hong-zhang, JIANG Si-yu, KUANG Min, DENG Lan-ping, TAN Ling-hui, ZHU Hui-bin, NING Xing-wang. Retrospective analysis on changes in clinical distribution and antimicrobial resistance of 2,426 strains of Klebsiella pneumonia, 2017-2020. , 2022, 29(1): 42-45.
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2022, Vol. 29 
