Changes of distribution and antimicrobial resistance of klebsiella pneumoniae in Shandong Provincial Hospital from 2015 to 2017 / 中国小儿急救医学

ABSTRACT

Objective To investigate the antimicrobial resistance and distribution of klebsiella pneu‐moniae in Shandong Provincial Hospital and to provide a reference for clinical treatment. Methods The specimens collected in our hospital from January 1,2015 to December 31,2017 were cultured. The drug sensi‐tivity test was carried out according to the unified scheme by paper diffusion method or automated instrument method. The results were interpreted according to the CLSI 2014 M100‐S24,and the data were analyzed by using WHONET5. 6 software. Results From 2015 to 2017,a total of 79 615 specimens were sent to the hos‐pital for bacterial culture,and 2 159 strains of klebsiella pneumoniae (non‐repeat bacteria) were isolated,with a separation rate of 9. 87%, 9. 23% and 9. 98%, respectively. The detection rates of extended spectrum β‐lactamase(ESBLs)‐producing klebsiella pneumoniae strains were 37. 97%,43. 57% and 40. 87% respec‐tively. The specimens were mainly separated from sputum,blood,urine,skin soft tissue,ascites and cerebro‐spinal fluid. Except for the slight decrease in ESBLs‐producing rate of klebsiella pneumoniae in sputum cul‐ture specimens in 2017,other specimens showed an increasing trend year by year,especially in blood culture specimens. The ESBLs production rate of klebsiella pneumoniae increased from 24. 53% in 2015 to 55. 00%in 2017. The drug resistance rate of ESBLs‐producing strains to various antibacterial drugs was significantly higher than that of non‐ESBLs producing strains. ESBLs‐producing klebsiella pneumoniae had a high drug re‐sistance rate to most antibiotics,and it was most sensitive to carbapenems,with drug resistance rates lower than 17%. However,the rate of carbapenem‐resistant showed a rapid rise. Conclusion Klebsiella pneumoni‐ae is a common pathogenic bacteria in clinical practice, and the drug resistance rate of ESBLs producing strains is high. Strengthening the monitoring of bacterial resistance and infection control measures are very important for the effective treatment of bacterial infection.