Sources of Klebsiella pneumoniae Isolated in a Hospital in the Past Decade and Trends and Changes of in vitro Drug Susceptibility

Abstract

To investigate the source of Klebsiella pneumoniae (KP) isolated in a hospital in the past decade and the in vitro drug susceptibility, and to provide clinical references for the treatment of KP-associated infection. The detection rate, the sources of the specimens, and in vitro susceptibility to antimicrobial agents of KP isolated from clinical specimens in a hospital between January 2012 and December 2021 were retrospectively analyzed. Resistance rate of the extended-spectrum β-lactamases-producing isolates vs. that of the non-enzyme-producing ones, and the resistance rate of imipenem-resistant strains vs. that of imipenem-susceptible ones were compared and analyzed. Carbapenase inhibitor enhancement test was used to identify the types of the carbapenemases. In total, 34 573 strains of KP were isolated from 1 684 668 clinical specimens, accounting for 14.6% of bacterial isolates. There were 16 888 non-repeated strains of KP. The main specimen sources of the isolates were sputum (10 274/16 888, 60.8%), blood (1 913/16 888, 11.3%) and urine (1 876/16 888, 11.1%). The proportion of extended-spectrum β-lactamases-producing isolates increased from 29.6% (409/1 382) in 2012 to 38.9% (967/2 487) in 2021, and the resistance rate to antimicrobial agents was higher than that of non-enzyme-producing ones ( P<0.05). The proportion of imipenem-resistant strains increased from 3.2% (44/1 382) in 2012 to 23.4% (583/2 487) in 2021, and the resistance rate to antimicrobial agents was higher than that of imipenem-susceptible strains ( P<0.05). Serine carbapenase-producing strains accounted for 91.1% (920/1010). The resistance to antimicrobial agents of KP strains isolated from clinical specimens increased. It is necessary to monitor the in vitro drug susceptibility and the type of the carbapenemases of the isolates in order to provide guidance for the clinical usage of antibiotics.