Background: Klebsiella pneumoniae (KP) is a common opportunistic pathogen in hospitalized patients, often causing pneumonia, urinary tract infection, and bacteremia. Gastrointestinal carriage is a risk factor for nosocomial infections.
Purpose: The purpose was to determine the pattern of Klebsiella pneumoniae (KP) infection and
drug resistance through long-term and large sample-size statistical analysis
and to provide epidemiological data for the treatment, prevention, and control
of multidrug-resistant bacterial infection in the hospital.
Patients and Methods: In this study, 5442 strains of Klebsiella pneumoniae were collected
from the First Affiliated Hospital of Hebei North University of China from
January 1, 2014, to June 30, 2022. Strains were identified using the BD
PhoenixTM100 system, minimal inhibitory concentrations of antibiotics were
determined by the broth method, and data were statistically analyzed using
WHONET 5.6 and SPSS27.0.
Results: The study found that the isolation rate of KP from
Enterobacteriaceae (26.2%, 4547/17358) in our hospital showed an increasing
annual trend, ranking second only to Escherichia coli. Carbapenem-resistant KP
(CRKP) accounted for the highest proportion of carbapenem-resistant
Enterobacteriaceae (72.2%, 431/597), showing an upward trend. Infected patients
had a male-to-female ratio of approximately 2:1 and were mainly >60 years of
age (66.2%), with intensive care units being the most commonly distributed
department. Sputum was the most common specimen type (74.0%). Compared with
spring and summer, autumn and winter were the main epidemic seasons for KP and
extended-spectrum β-lactamase KP (ESBL-KP). The resistance rate of KP to common
antibiotics was low, but all showed an increasing trend each year. ESBL-KP was
>90% resistant to piperacillin, amoxicillin/clavulanic acid, and cefotaxime
and less resistant to other common antibiotics, but showed an increasing trend
in resistance to most antibiotics. CRKP resistance to common antibiotics was
high, with resistance rates >90%, excluding amikacin (64.1%), gentamicin
(87.4%), cotrimoxazole (44.3%), chloramphenicol (13.6%), and tetracycline
(30.5%). Additionally, the detection rate of CRKP showed a rapidly increasing
trend from 2014 to 2018, and then a slowly decreasing trend from 2018 to 2022,
while ESBL-KP showed an initially increasing trend, followed by another
decrease, then an increase.
Conclusion: KP in our hospital mainly caused pulmonary infection
in older men, which occurred frequently in autumn and winter, and the isolation
and drug resistance rates showed an increasing trend. Age over 70 years,
admission to the intensive care unit, and urinary tract infection were found to
be the risk factors for CRKP and ESBL-KP resistance. It is recommended that in
the face of the high transmission and mortality of CRE, the WHO should actively
strengthen international collaborations to study and develop new antibiotics
against third-generation cephalosporins and CRE to jointly curb the spread of
multi-drug resistance.
Author
(s) Details
Na Wang
Microbiology Department, The First Affiliated Hospital of Hebei
North University, Zhangjiakou, People’s Republic of China.
Minghua
Zhan
Clinical Laboratory, The First Affiliated Hospital of Hebei North
University, Zhangjiakou, People’s Republic of China.
Teng
Wang
Otolaryngology Head and Neck Surgery, The First Affiliated
Hospital of Hebei North University, Zhangjiakou, People’s Republic of China.
Jinlu
Liu
Microbiology Department, The First Affiliated Hospital of Hebei
North University, Zhangjiakou, People’s Republic of China.
Caiqing
Li
Microbiology Department, The First Affiliated Hospital of Hebei
North University, Zhangjiakou, People’s Republic of China.
Baoliang
Li
Microbiology Department, The First Affiliated Hospital of Hebei
North University, Zhangjiakou, People’s Republic of China.
Xuying
Han
Microbiology Department, The First Affiliated Hospital of Hebei
North University, Zhangjiakou, People’s Republic of China.
Huiying
Li
Obstetrics and Gynecology Department, The First Affiliated
Hospital of Hebei North University, Zhangjiakou, People’s Republic of China.
Shuting
Liu
Hemodialysis Department, The First Affiliated Hospital of Hebei
North University, Zhangjiakou, People’s Republic of China.
Jing
Cao
Microbiology Department, The First Affiliated Hospital of Hebei
North University, Zhangjiakou, People’s Republic of China.
Xinran
Zhong
Microbiology Department, The First Affiliated Hospital of Hebei
North University, Zhangjiakou, People’s Republic of China.
Chunmei
Lei
Microbiology Department, The First Affiliated Hospital of Hebei
North University, Zhangjiakou, People’s
Republic of China.
Wei
Zhang
Microbiology Department, The First Affiliated Hospital of Hebei
North University, Zhangjiakou, People’s Republic of China.
Zhihua
Zhang
Respiratory and Critical Care Medicine, The First Affiliated
Hospital of Hebei North University, Zhangjiakou, People’s Republic of China.
Please see the book here:- https://doi.org/10.9734/bpi/rpmab/v7/2284
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