Analysis on clinical manifestations and drug resistance of Klebsiella pneumoniae pneumonia in children

Abstract

Objective To determine the clinical features of Klebsiella pneumoniae pneumonia and antimicrobial resistance of Klebsiella pneumoniae, providing the basis for rational use of antibiotics. Methods Eighty-six strains of Klebsiella pneumoniae were isolated from the sputum specimen which collected from the inpatients in our hospital from Dec 2008 to Dec 2010,which were identified with Bio Merieum Vitek 2. A total of 86 children were enrolled in the study, which were divided into hospital infection/colonization group (n = 68) and community infection group (n = 18). Clinical information were recorded. Extended spectum β-lactamase (ESBLs) and antibiotic susceptibility of Klebsiella pneumoniae were determined. Results Klebsiella pneumoniae pneumonia in children mainly occured in infants, especially in infants with basic diseases.Clinical manifestations of Klebsiella pneumoniae pneumonia had no much difference from common pneumonia. The detection rate of ESBLs was high(76. 7%). ESBLs were found in 64 strains of the hospital infection/colonization group (94. 1% ,64/68) ,while in 2 strains of the community infection group (11. 1% ,2/18).There was a significant difference between the two groups (P ＜0. 01). The drug resistance of hospital infection/colonization group was significantly higher than that of community infection group. The strains of hospital infection/colonization group were sensitive with cefotan, piperacillin/tazobactam, carberpenem, amikacin and ciprofioxacin only, while were highly resistant to penicillins, cephalosporins and monoamine antibiotics.The average hospital stay of the hospital infection/colonization group was (15.0 ± 7. 1) d, while the other was (8. 2 ± 3. 8) d. There was a very significant difference between the two groups in average length of stay (P＜0.01). Conclusion Klebsieila pneumoniae pneumonia in children mainly occurs in infants with basic diseases. The symptoms are untypical. Klebsiella pneurmoniae multi-drug resistance is a serious problem,which must be paid attention to. We should make a difference between the two groups when antibiotics were prescribed. Key words: Klebisella pneumoniae; β-lactamase; Drug susceptibility; Children