Surveillance of drug resistance and molecular epidemiological characteristics of carbapenem-resistant Klebsiella pneumoniae in a grade A tertiary hospital of Sanya
OBJECTIVE To investigate the changes of drug resistance and molecular epidemiological characteristics of Klebsiella pneumoniae(KP)and carbapenem-resistant Klebsiella pneumoniae(CRKP)in a grade A tertiary hospital in Sanya during the past seven years.METHODS The results of drug susceptibility of KP and CRKP strains isolated from Sanya Central Hospital(the Third People's Hospital of Hainan Province)during 2016 and 2022 were collected.Molecular characteristics such as drug-resistant genotypes of carbapenems were analyzed and detected by multilocus sequence typing(MLST).And the characteristics of epidemic strains were analyzed.RESULTS A total of 3 994 strains of KP were isolated from 2016 to 2022.The detection rate in the neurosurgery department was the highest(14.65％),which was mainly isolated from sputum(76.56％).The drug resistance rate to amikacin and tigacycline was low,and the drug resistance rate to cephalosporin was high.The drug resist-ance rate to common antibiotics showed a decreasing trend in seven years(P＜0.05).A total of 45 strains of CRKP were isolated between 2016 and 2022,and the detection rate was the highest in the paediatrics department(28.88％),mainly from sputum(60.00％).The drug-resistant rate to enzyme inhibitors was＞88.00％,and the drug-resistant rate to cephalosporins was＞93.00％.The drug-resistant rate to tigacycline was low.The geno-types of carbapenemase gene detected were NDM,KPC,IMP and VIM,and patinets carrying two genotypes at the same time.The main type of CRKP isolated in the paediatrics department were KPC,accounting for 23.08％.A total of 26 ST types were obtained by MLST classification,and ST571(20.00％)was the dominant type,which was the main epidemic strain and closely related to the epidemic in community.CONCLUSION From 2016 to 2022,the drug-resistant rate of KP isolated from this hospital to commonly used antibiotics decreases.CRKP is highly drug-resistant to common antibiotics,and mainly carries NDM carbapenemase as the main drrug resistance mecha-nism.The molecular typing of strains are dynamic and diverse,and the dominant ST571 CRKP clone is prevalent and spreads in hospitals.Prevention and control of nosocomial infection should be strengthened.
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