Clinical characteristics，molecular typing and drug resistance genes of carbapenem-resistant Klebsiella pneumoniae isolated from blood culturing

doi:10.3969/j.issn.1673-8640.2023.04.012

Abstract

Abstract:

Objective To analyze the clinical characteristics and drug resistance genes of carbapenem-resistant Klebsiella pneumoniae（CRKP） isolated from blood culturing，and to provide a reference for clinical antibiotic usage. Methods Totally，153 CRKP isolates from blood culturing in Xinhua Hospital of Shanghai Jiao Tong University School of Medicine from 2010 to 2019 were collected. Multilocus sequence typing（MLST） was carried out in the 153 CRKP isolates. The drug resistance genes of carbapenemase were determined. The clinical data were collected，and the clinical characteristics of CRKP were analyzed. Results The determination rate of CRKP showed a trend of increasing from 2010 to 2019. The 71.24%（109/153） CRKP were isolated from intensive care unit（ICU），and 52.29% of the patients were adults，which were >60 years old（72.50%）. Meanwhile，64.38% of the patients were infants ≤1 year old. The 64.71% of patients were discharged. According to the MLST results，86.92% CRKP（153 isolates） were ST11，29.32% of related patients were from pediatric ICU，and 18.80% were from surgery ICU. The carbapenem-resistant gene screening results showed that 131 isolates of CRKP carried bla_KPC-2，11 isolates carried bla_NDM-1，4 isolates bla_NDM-5，and the other 7 isolates had no carbapenem-resistant genes. The 129 of 131（98.47%） bla_KPC-2 carried CRKP were ST11，and the determination rate reached 84.31%（129/153）. Both bla_NDM-1 CRKP and bla_NDM-5 CRKP were non-ST11，and most of the related patients were infants ≤1 year old. Conclusions The determination rate of CRKP from blood culturing shows an increasing trend in Xinhua Hospital of Shanghai Jiao Tong University School of Medicine. The main drug resistance gene is ST11 bla_KPC-2，and the prevalence is mainly occurred in ICU.

Key words: Carbapenem-resistant Klebsiella pneumoniae, Clinical characteristic, Multilocus sequence typing, Drug resistance gene

CLC Number:

R446.1

WANG Jiawei, ZHU Weinan, CHEN Yingying, JI Ping, WANG Ying. Clinical characteristics，molecular typing and drug resistance genes of carbapenem-resistant Klebsiella pneumoniae isolated from blood culturing[J]. Laboratory Medicine, 2023, 38(4): 362-367.

Figures/Tables 6

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年份	菌株数/株	百分比/%
2010年	1	0.65
2011年	2	1.31
2012年	1	0.65
2013年	4	2.61
2014年	9	5.88
2015年	9	5.88
2016年	23	15.03
2017年	33	21.57
2018年	39	25.49
2019年	32	20.92

年份	菌株数/株	百分比/%
2010年	1	0.65
2011年	2	1.31
2012年	1	0.65
2013年	4	2.61
2014年	9	5.88
2015年	9	5.88
2016年	23	15.03
2017年	33	21.57
2018年	39	25.49
2019年	32	20.92

病区	菌株数/株	百分比/%
儿童ICU	47	30.72
外科ICU	25	16.34
老年ICU	12	7.84
儿外科	12	7.84
新生儿ICU	10	6.54
脑外科ICU	9	5.88
普外科	8	5.23
急诊ICU	6	3.92
其他	24	15.69

病区	菌株数/株	百分比/%
儿童ICU	47	30.72
外科ICU	25	16.34
老年ICU	12	7.84
儿外科	12	7.84
新生儿ICU	10	6.54
脑外科ICU	9	5.88
普外科	8	5.23
急诊ICU	6	3.92
其他	24	15.69

临床特征	例数/例	百分比/%
性别
男	109	71.24
女	44	28.76
年龄
儿童	73	47.71
≤1岁	47	30.72
>1~7岁	25	16.34
>7~15岁	1	0.65
成人	80	52.29
16~60岁	22	14.38
>60岁	58	37.91
疾病类型
糖尿病	18	11.76
高血压	32	20.92
尿路感染	19	12.41
肺部感染	7	4.58
侵入性操作
机械通气	80	52.29
近期手术	121	79.08
置留导管	137	89.54
预后
痊愈	99	64.71
死亡	42	27.45
继续治疗	12	7.84