Disease burden and molecular epidemiology of carbapenem-resistant Klebsiella pneumonia infection in a tertiary hospital in China

Abstract

BackgroundCarbapenem-resistant Klebsiella pneumoniae (CRKP) has become an urgent global public health issue, but its distribution has obvious regional differences. The purpose of this study was to investigate the patient-based disease burden and molecular epidemiology of CRKP infections in a tertiary hospital in northern Jiangsu Province in China.MethodsA retrospective, epidemiological survey of CRKP infections in our hospital from January to December 2016 was conducted to collect clinical and epidemiologic data. Non-duplicated clinical CRKP isolates were collected for the resistance-associated genes and clonal correlation analysis by PCR, sequencing and multilocus sequence typing (MLST).Results252 CRKP infection cases were collected, and the annual CRKP infection incidence of the hospital during 2016 was 14.64 per 10,000 hospital discharges (252/172,112*10,000) and 13.78 per 100,000 patient days (252/1,829,190*100,000). The patient-based disease burden concentrated on antimicrobial exposure history (133/224, 59.37%)—the most dominant STs. KPC-2 (120/128, 93.8%) was the predominant carbapenemase and ST11 (98/128, 76.5%) was the dominant STs. One isolate was detected with harboring blaKPC-2 and blaMCR-1 simultaneously.ConclusionsPatient-based disease burden and KPC-2-producing ST11 Klebsiella pneumonia caused in higher CRKP incidence in the hospital. The emergence of CRKP with blaKPC-2 and blaMCR-1 should be of concern.