Analysis of Clinical Distribution and Drug Resistance of Klebsiella pneumoniaein a Hospital
Objective To analyze the clinical distribution and drug resistance of Klebsiella pneumoniae in Dalian Friendship Hospital from 2017 to 2022,and to provide a theoretical basis for the clinical treatment of Klebsiella pneumoniae infection.Methods A total of 1865 strains of Klebsiella pneumoniae were collected from Dalian Friendship Hospital from 2017 to 2022.The clinical distribution and drug sensitivity were analyzed by whole 5.6.The drug resistance rate of bacteria in six years was analyzed by x2 test with SPSS22.0 software,and P≤0.05 was used as the criterion.Results The isolation rate of Klebsiella pneumoniae was the highest in sputum specimens(956 strains,51.26％),and the highest in clinical departments was the Department of Critical Medicine(734 strains,39.36％).While the resistance rate of Amikacin(17.6％)to aminoglycosides,carbapenems,and tetracyclines was very low,the resistance rate of Klebsiella pneumoniae to penicillins,cephalosporins,and quinolones was relatively high,with Cefazolin having the highest rate at 69.8％.Resistance rates were lower in 2019(P＜60％)and higher in 2022(＞70％)with piperacillin(75.6％),ampicillin sulbactam(72.8％),and Ciprofloxacin(72.7％).There were 18 antibiotics that changed significantly in six years(P＜0.05).From 2017 to 2018,there were significant changes in the resistance rates of eight classes of drugs(P＜0.05),resistance rates to cefotetan and ceftazidime were significantly reduced,while resistance rates to piperacillin tazobactam,cefoperazone sulbactam,cefazolin,Ciprofloxacin,gentamicin and Tobramycin were significantly increased;In 2020,the drug resistance rate of Minocycline and Levofloxacin increased significantly,while the drug resistance rate of 2021 Minocycline decreased significantly and the drug resistance rate of gentamicin increased significantly;In 2022,resistance to all 20 classes of drugs increased,Piperacillin,piperacillin tazobactam,ampicillin sulbactam,cefoperazone sulbactam,ceftriaxone,imipenem,meropenem,Levofloxacin,amikacin and Tobramycin 10 drugs increased significantly(P＜0.05).Conclusion A six-year surveillance study revealed a rising trend in drug resistance to 20 kinds of medications,with enzyme inhibitor medicines,carbapenems,quinolones,and aminoglycosides showing particularly high rates of drug resistance in 2022 due to the major outbreak.In the post-epidemic era,surveillance of bacterial resistance should be strengthened,especially for Klebsiella pneumoniae resistant to enzyme inhibitors,third-generation cephalosporins and carbapenems.At the same time,the use of broad-spectrum antibiotics should be controlled to slow down the drug resistance.
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