https://orcid.org/0000-0003-2600-2162
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Abstract
Purpose
Through long-term and large sample size statistical analysis, we revealed the pattern of Klebsiella pneumoniae (KP) infection and drug resistance and provided epidemiological data for the treatment and prevention and control of multidrug-resistant bacterial infection in our hospital.
Patients and Methods
Strains were identified using the BD PhoenixTM100 system, minimal inhibitory concentration of antibiotics were determined by the broth method, and data were statistically analyzed using WHONET 5.6 and SPSS27.0.
Results
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%).
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 intensive care unit, and urinary tract infection were found to be the risk factors for CRKP and ESBL-KP-resistance.
Abbreviations
CHINET, China Antibiotic Surveillance Network; CRE, carbapenem-resistant Enterobacteriaceae; CRKP, carbapenem-resistant Klebsiella pneumoniae; ESBL-KP, extended spectrum β-lactamase producing Klebsiella pneumoniae; ICU, intensive care unit; IMP, imipenemase; KP, Klebsiella pneumoniae; KPC, Klebsiella pneumoniae carbapenemase; MIC, minimum inhibitory concentration; NDM, New Delhi metallo-β-lactamase; OXA, oxacillinase; QC, quality control; TZP, piperacillin-tazobactam; VIM, Verona-intergona-encoded metallo-β-lactamase.
Data Sharing Statement
Data of this study can be available upon request from the author.
Ethics Approval and Informed Consent
The study was approved by the Ethics Committee of the First Affiliated Hospital of Hebei North University (ethical approval No. K2019147), which waived the requirement of written informed consent from patients. All strains are part of the routine laboratory procedures of the hospital and do not involve any human genetic resources. This study was conducted in accordance with the principles outlined in the Declaration of Helsinki.
Acknowledgments
We thank all colleagues in the Department of Microbiology of the First Affiliated Hospital of Hebei North University for technical support and experimental guidance. The author thanks Editage (www.editage.cn) for English language editing.
Author Contributions
All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Disclosure
The authors report no conflicts of interest in this work.