Analysis on clinical distribution and drug resistance of Klebsiella pneumoniae isolated for 5 consecutive years

Abstract

Objective: To analyze the clinical distribution and drug resistance of Klebsiella pneumoniae isolated from patients in a certain hospital and provide a basis for the rational use of antibiotics in the clinical treatment for the infection of Klebsiella pneumoniae.

Methods: 1,192 strains of Klebsiella pneumoniae isolated from clinical specimens from 2012 to 2016 were collected. The strains were identified by VITEK-2 Compact Microbiological Identification System, and the corresponding results of the antimicrobial susceptibility test were interpreted in accordance with the standards recommended by Clinical and Laboratory Standards Institute (CLSI).

Results: 1,192 strains of Klebsiella pneumoniae were mainly isolated from sputum (65.6%), and most of them were from Respiratory Medicine Department and Medical Intensive Care Unit of Respiratory Medicine Department (MICU), accounting for 41.4%. Out of 1,192 strains, 448 strains were detected to produce extended-spectrum beta-lactamases (ESBLs), accounting for 37.6%. In addition, the detection rates of ESBL-producing Klebsiella pneumoniae for 5 consecutive years showed an increasing trend year by year, and they were higher than the national average values published by China Antimicrobial Resistance Surveillance
System (CARSS) in the corresponding period. The drug resistance rate of ESBL-producing Klebsiella pneumoniae was significantly higher than that of non ESBL-producing strains.

Conclusions: The infection caused by Klebsiella pneumoniae mainly occurs in the lower respiratory tract, and the drug resistance rates of Klebsiella pneumoniae to antibiotics in the drug susceptibility spectrum are maintained at a high level. Therefore, the rational selection of antibiotics for the clinical treatment of lower respiratory tract infection caused by Klebsiella pneumoniae must be based on the production of ESBLs and the results of antimicrobial susceptibility test.