Analysis of Carbapenem-resistant Klebsiella Pneumoniae Antibiotic Resistance and Enzyme Production Phenotype in a Hospital from 2021 to 2023
Objective:To analyze the clinical distribution,drug resistance characteristics,and carbapenemase phenotypes of Carbap-enem-Resistant Klebsiella pneumoniae(CRKP)in a Class A tertiary hospital,aiming to provide a reference for developing effective CRKP control strategies.Methods:Retrospective analysis of the distribution,antibiotic resistance changes,and enzyme phenotypes of non-re-petitive CRKP strains isolated from inpatient specimens in a hospital between 2021 and 2023.Results:From 2021 to 2023,a total of 183 CRKP strains were detected,mainly from sputum(65.0％),urine(11.5％),and blood(10.4％).The departmental distribution was predominantly in the ICU(33.3％),followed by the respiratory department(24.0％)and neurosurgery(15.3％).The proportion of neurosurgery shows a decreasing trend year by year(P＜0.05),while the proportion of rehabilitation medicine shows an increasing trend year by year(P＜0.05).Susceptibility testing showed that CRKP was highly resistant to β-lactams,fluoroquinolones,and aminoglyco-sides,but more sensitive to tigecycline,polymyxin B and ceftazidime/avibactam;resistance to both levofloxacin and ciprofloxacin increased from 80.4％in 2021 to 100.0％in 2023(P＜0.05).Most CRKP produced carbapenemases,predominantly serine-type enzymes,with the proportion of strains producing class D serine carbapenemases(OXA-48)decreasing annually(P＜0.05).Conclusion:The CRKP strains isolated in this hospital are predominantly found in ICU wards,with pulmonary infections being the most common.These strains exhibit high resistance to most commonly used antibiotics,primarily due to the production of serine carbapenemas-es.The hospital must enhance monitoring in key departments,optimize antibiotic usage strategies,and implement precise control meas-ures to effectively curb the spread of CRKP.
万方数据
维普
