Antibiotic resistance profile and clinical characteristics of the Klebsiella pneumoniae strains isolated from blood cultures / 中国感染与化疗杂志

ABSTRACT

Objective To analyze the changing antibiotic resistance profile of the Klebsiella pneumoniae strains isolated from blood cultures during the last 9 years in our hospital for rational use of antibiotics. Methods Antibiotic resistance of the K. pneumoniae strains isolated from blood cultures from 2009 to 2017 was retrospectively analyzed. Medical records of the corresponding inpatients were reviewed and analyzed. Results A total of 6 917 bacterial strains were isolated from blood cultures between 2009 and 2017, of which 311 strains (4.5％) were Klebsiella pneumoniae. Complete antimicrobial susceptibility data were available for 298 of the 311 strains. The K. pneumoniae strains isolated from blood cultures showed increasing resistance rate to the antimicrobial agents in the nine-year period. The resistance rates to piperacillin-tazobactam, cefotetan, amikacin, carbapenem antibiotics increased from 0 to 48.6％. The prevalence of CRKP increased from 0 in 2009 to 48.7％ in 2017. The inpatients with K. pneumoniae isolate from blood cultures were mainly found in general surgery, cardio-thoracic surgery department, emergency room, and pediatrics surgery department. Significant difference was found between CRKP-associated inpatients and non-CRKPassociated inpatients in the time to detection of K. pneumoniae, exposure to antimicrobial agents, invasive procedure, length of hospital stay, and prognosis (P＜0.001). Conclusions The antibiotic resistance profile of the K. pneumoniae strains isolated from blood cultures showed a rising tendency during the period from 2009 to 2017. Clinical microbiology laboratory should pay more attention to strengthening antibiotic resistance surveillance. Clinicians should reduce the use of invasive procedures and use appropriate antimicrobial agents to prevent the emergence of antibiotic-resistant strains.