Drug resistance and homology of polymyxin-resistant Klebsiella pneumoniae
OBJECTIVE To understand the drug resistant characteristics,clinical distribution,drug resistance phe-notypes and genotypes of the polymyxin-resistant Klebsiella pneumoniae strains.METHODS Totally 17 strains of polymyxin-resistant K.pneumoniae were isolated from Ruijin Hospital Affiliated to Shanghai Jiao Tong Universi-ty from Jan 2021 to Dec 2021.The strains were identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry(MALDI-TOF MS),the drug susceptibility testing was carried out by using Vitek-2 Compact automatic microorganism analyzer,the susceptibility to polymyxin was confirmed by broth dilution method,the drug resistance genotypes that were carried by the strains were amplified by PCR,the sequences were analyzed,and the homology among the strains was observed.RESULTS Among the 17 strains of polymyxin-re-sistant K.pneumoniae,4(23.5％)were isolated from blood,and 11(64.7％)were isolated from ICU.The drug resistance rates of the polymyxin-resistant K.pneumoniae strains to β-lactamse inhibitor compounds,cefepime,ciprofloxacin and levofloxacin were 100％.All of the strains carried with blaSHV and blaTEM,mcr gene was not detected.Multilocus sequence typing(MLST)showed that 16(94.1％)strains were ST-11 type.Totally 17 patients from whom the polymyxin-resistant K.pneumoniae strains were isolated were complicated with mul-tiple underlying diseases,13 of 17(76.5％)were male,the age ranged between 37 and 96 years old,the length of hospital stay ranged between 33 and 146 days.9(52.9％)cases died,and 4(23.5％)cases did not receive any colistin-related therapy.The phylogenetic tree showed that there was homology among the 15 strains of polymyx-in-resistant K.pneumoniae isolated from different sites.CONCLUSION The polymyxin-resistant K.pneumoniae strains are pandrug-resistant strains,most of which carry with multiple drug resistance genes,posing great diffi-culties to treatment.It is necessary for the hospital to attach great importance,strengthen prevention and control of drug-resistant strains and reasonably use antibiotics.
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