Drug resistance and molecular epidemiological characteristics of Klebsiella pneumoniae in children with bloodstream infection in a Class Ⅲ hospital in Shanghai
Objective To investigate the antimicrobial resistance and molecular epidemiological characteristics of Klebsiella pneumoniae(KP)in children with bloodstream infection in a hospital in Shanghai.Methods Blood samples were collected from children with bloodstream infections who received treatment at Shanghai Children's Hospital from January 2021 to November 2022.PK strains were isolated,cultured and identified.Drug resistance was determined using the paper diffusion(K-B)method,and drug resistance genes were detected.Capsular serotype,virulence genes and multi-locus sequence typing(MLST)were analyzed through whole genome sequencing.Results A total of 74 KP strains were detected in 120 blood samples,re-sulting in a total detection rate of 61.67%(74/120).The highest resistance rate among the 74 KP strains was to ampicillin/sulbactam at 35.14%.The drug resistance rates to piperacillin/tazobactam,imipenem and levofloxa-cin were 20.27%,21.62%and 22.97%,respectively.Drug resistance gene detection showed that the blaKPC gene carrying rate in Klebsiella pneumoniae was the highest at 21.62%(16/74).Mucosal blood type and viru-lence gene detection showed that K64 KP was the most prevalent with 28 strains(37.84%).ST typing results showed that 32 ST types were identified among the 74 KP strains,with ST23 being the most common at 9.46%(7/74),followed by ST29,ST111,ST412,ST36,ST20 and ST37.Conclusion The drug resistance of KP in children with bloodstream infections is still relatively low.However,there are still some antimicrobial resis-tant strains and multiple drug-resistant strains of KP.Additionally,the carrying rate of drug-resistant genes and toxic genes is high,which should be a cause for concern.
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