Analysis of Clinical Distribution Characteristics,Drug Resistance Genes,and Related Risk Factors of Patients with Carbapenem-Resistant Klebsiella Pneumoniae Infection
Analysis of Clinical Distribution Characteristics,Drug Resistance Genes,and Related Risk Factors of Patients with Carbapenem-Resistant Klebsiella Pneumoniae Infection
Objective To investigate the distribution characteristics,drug resistance genes and related risk factors of carbapenem-resistant Klebsiella pneumoniae(CRKP)infection,so as to avoid the unreasonable use of antibiotics.Methods The clinical data of 619 patients diagnosed with Klebsiella pneumoniae(KPN)infection from January 2017 to Sep-tember 2021 were retrospectively analyzed.The distribution characteristics of CRKP infection and drug resistance genes were statistically analyzed,and the risk factors of CRKP infection were analyzed by univariate and multivariate Logistic regression.Results Of the 619 patients,51(8.24%)had CRKP and 568(91.76%)had carbapenem-sensitive Klebsiella pneumoniae(CSKP).Compared with CSKP group,the proportion of nosocomial infection,bacteria distribution in neurology department and carbapenems used within 1 month in CRKP group was higher,while the proportion of bacteria distribution in respiratory department was lower.In addition,the drug resistance rate of the CRKP group to polyphosphate,intermediate-acting sulfona-mides,aminoglycosides,carbapenems,cephalosporins,penicillins and Quinolone antibiotics was higher(P＜0.05,P＜0.01).PCR amplification of drug resistance genes showed that 30(58.9%)of 51 CRKP strains carried blaKPC-2 gene,18(35.3%)carried blaNDM gene,2(3.9%)carried blaIMP gene and 1(1.9%)carried blaOXA-48 gene.Two other strains(3.9%)carried both blaKPC-2 and blaNDM genes.Multivariate logistic regression analysis showed that serum albumin＜35 g/L,Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score≥20,duration of indwelling catheter and mechanical ventilation≥7 d,use of carbapenems within 1 month,use of≥3 antibiotics,length of hospital stay≥20 d,and carrying multiple drug-resistant bacteria were independent risk factors for CRKP infection(P＜0.05,P＜0.01).Conclusion CRKPaccounts for a relatively high proportion of nosocomial infections,and detecting CRKP resistance and re-sistance genes can guide the rational selection of antibiotics in clinical practice,thereby reducing the occurrence of resistance and preventing CRKP infection.
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