Investigation on the Influencing Factors and Drug Resistance of Klebsiella Pneumoniae Infection in Hospital
[Objective]To explore the influencing factors and drug resistance of Klebsiella pneumoniae in hospi-tal acquired infections.[Methods]A total of 87 patients with hospital acquired infections admitted to our hospital from March 2018 to January 2023 were selected as the study subjects.Among them,28 patients with hospital ac-quired infections of Klebsiella pneumoniae were included in the observation group,and 59 patients with hospital ac-quired infections of Acinetobacter baumannii were included in the control group.Two sets of general information were compared;Strain source,drug resistance,and virulence genes;The influencing factors and drug resistance of Klebsiella pneumoniae infection in the hospital were analyzed.[Results]In the observation group,21 cases(75.00%)were positive for mixed infections,including 5 cases(23.81%)of type A(Streptococcus pneumoniae),4 cases(19.05%)of type B(Staphylococcus aureus),2 cases(9.52%)of type C(Haemophilus influenzae),4 cases(19.05%)of type A+B,2 cases(9.52%)of type A+C,3 cases(14.29%)of type B+C,and 1 case(4.76%)of type A+B+C.In the control group,26 cases(44.07%)were positive for mixed infections,including 6 cases of type A(23.08%),5 cases of type B(19.23%),4 cases of type C(15.38%),3 cases of type A+B(8.69%),3 ca-ses of type A+C(11.54%),4 cases of type B+C(15.38%),and 1 case of type A+B+C(3.85%).There was no statistically significant difference(P>0.05)in age,gender,length of hospital stay,albumin levels,department distribution,white blood cell count(WBC)and indwelling catheter count,invasive procedures,and the proportion of infected patients staying in the same ward for ≥ 1 week or with incomplete final disinfection between the two groups;The observation group had a higher proportion of long-term use of broad-spectrum antibiotics,combined with at least 2 other bacterial infections,and early colonization of Klebsiella pneumoniae than the control group(P<0.05).The results of logistic regression analysis showed that long-term use of broad-spectrum antibiotics,concur-rent infection with ≥2 other bacteria,and early colonization of Klebsiella pneumoniae were risk factors for hospital acquired Klebsiella pneumoniae infection in patients(P<0.05).28 strains of bacteria mainly come from sputum and blood;Klebsiella pneumoniae has the highest resistance to piperacillin/tazobactam and ceftriaxone(100%),while it has the lowest resistance to tigecycline(3.57%)and tetracycline(7.14%);Among the 28 strains,6 strains(21.43%)were high mucinous and 22 strains(78.57%)were non high mucinous.The positive rate of high mucin-ous strains in the wire drawing test was higher than that of non mucinous strains(P<0.05);The positive rates of virulence genes iroN,rmpA,and ybtS in high mucinous strains were higher than those in non mucinous strains(P<0.05).[Conclusion]Long term use of broad-spectrum antibiotics,combined with at least 2 other bacterial infec-tions,and early colonization of Klebsiella pneumoniae are risk factors for patients to be infected with Klebsiella pneumoniae.Klebsiella pneumoniae is more resistant to common antibiotics.
Klebsiella pneumoniaeCross InfectionDrug Resistance,MultipleRoot Cause Analysis