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

SHU Ling; DENG Jin; ZHANG Wei-li; WU Chong-yang; YUAN Yu; HE Chao

doi:10.12182/20220760507

Volume 53 Issue 4

Jul. 2022

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JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCES) > 2022 > 53(4): 696-700. > DOI: 10.12182/20220760507

SHU Ling, DENG Jin, ZHANG Wei-li, et al. Sources of Klebsiella pneumoniae Isolated in a Hospital in the Past Decade and Trends and Changes of in vitro Drug Susceptibility[J]. Journal of Sichuan University (Medical Sciences), 2022, 53(4): 696-700. DOI: 10.12182/20220760507

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

Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China

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Corresponding author:
HE Chao, E-mail: hc_wsw@126.com
Received Date: March 07, 2022
Revised Date: June 19, 2022
Available Online: July 21, 2022
Published Date: July 19, 2022

Abstract

Abstract

Objective 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.
Methods 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.
Results 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).
Conclusion 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.
- Klebsiella pneumoniae,
- Extended-spectrum β-lactamases,
- in vitro susceptibility,
- Carbapenemase

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References

[1]	NORDMANN P, POIREL L. Epidemiology and diagnostics of carbapenem resistance in gram-negative bacteria. Clin Infect Dis,2019,69(Suppl 7): S521–S528. DOI: 10.1093/cid/ciz824
[2]	TRECARICHI E M, PAGANO L, MARTINO B, et al. Bloodstream infections caused by Klebsiella pneumoniae in onco-hematological patients: clinical impact of carbapenem resistance in a multicenter prospective survey. Am J Hematol,2016,91(11): 1076–1081. DOI: 10.1002/ajh.24489
[3]	胡付品, 郭燕, 朱德妹, 等. 2020年中国CHINET细菌耐药性监测. 中国感染与化疗杂志,2021,21(4): 377–387.
[4]	全国细菌耐药监测网. 2020年全国细菌耐药监测报告. 中华检验医学杂志,2022,45(2): 122–136. DOI: 10.3760/cma.j.cn114452-20211118-00721
[5]	Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing. M100-S31. Wayne, PA: CLSI, 2021.
[6]	王辉. 多黏菌素类与替加环素及头孢他啶/阿维巴坦药敏方法和报告专家共识. 中华检验医学杂志,2020,43(10): 964–972. DOI: 10.3760/cma.j.cn114452-20200719-00619
[7]	Centers for Disease Control and Prevention (CDC). Facility guidance for control of carbapenem-resistant Enterobacteriaceae(CRE). [2020-07-01][2022-03-01]. https://www.cdc.gov/hai/pdfs/cre/cre-guidance-508.pdf.
[8]	喻华, 徐雪松, 李敏, 等. 肠杆菌目细菌碳青霉烯酶的实验室检测和临床报告规范专家共识. 中国感染与化疗杂志,2020,20(6): 671–680. DOI: 10.16718/j.1009-7708.2020.06.015
[9]	LEE CR, LEE JH, PARK KS, et al. Global dissemination of carbapenemase-producing Klebsiella pneumoniae: epidemiology, genetic context, treatment options, and detection methods. Front Microbiol, 2016, 7: 895 [2022-03-01]. https://doi.org/10.3389/fmicb.2016.00895.
[10]	MARTIN RM, BACHMAN MA. Colonization, infection, and the accessory genome of Klebsiella pneumoniae. Front Cell Infect Microbiol, 2018, 8: 4 [2022-03-01]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5786545/. doi: 10.3389/fcimb.2018.00004.
[11]	HU Y, LIU C, SHEN Z, et al. Prevalence, risk factors and molecular epidemiology of carbapenem-resistantKlebsiella pneumoniae in patients from Zhejiang, China, 2008-2018. Emerg Microbes Infect,2020,9(1): 1771–1779. DOI: 10.1080/22221751.2020.1799721
[12]	LIAO W, HUANG N, ZHANG Y, et al. Comparison of carbapenem-resistant Klebsiella pneumoniae strains causing intestinal colonization and extraintestinal infections: Clinical, virulence, and molecular epidemiological characteristics. Front Public Health, 2021, 9: 783124[2022-03-01]. https://doi.org/10.3389/fpubh.2021.783124.
[13]	CHEN Y, ZHANG L, QIN T, et al. Evaluation of neurosurgical implant infection rates and associated pathogens: Evidence from 1118 postoperative infections. Neurosurg Focus,2019,47(2): E6. DOI: 10.3171/2019.5.FOCUS18582
[14]	BENGOECHEA J A, SA PESSOA J. Klebsiella pneumoniae infection biology: Living to counteract host defences. FEMS Microbiol Rev,2019,43(2): 123–144. DOI: 10.1093/femsre/fuy043
[15]	WANG G, ZHAO G, CHAO X, et al. The characteristic of virulence, biofilm and antibiotic resistance of Klebsiella pneumoniae. Int J Environ Res Public Health,2020,17(17): 6278. DOI: 10.3390/ijerph17176278
[16]	SHU L B, LU Q, SUN R H, et al. Prevalence and phenotypic characterization of carbapenem-resistant Klebsiella pneumoniae strains recovered from sputum and fecal samples of ICU patients in Zhejiang Province, China. Infect Drug Resist,2018,12: 11–18. DOI: 10.2147/IDR.S175823
[17]	HAN J H, GOLDSTEIN E J, WISE J, et al. Epidemiology of carbapenem-resistant Klebsiella pneumoniae in a network of long-term acute care hospitals. Clin Infect Dis,2017,64(7): 839–844. DOI: 10.1093/cid/ciw856
[18]	XU L, SUN X, MA X. Systematic review and meta-analysis of mortality of patients infected with carbapenem-resistant Klebsiella pneumoniae. Ann Clin Microbiol Antimicrob,2017,16(1): 18. DOI: 10.1186/s12941-017-0191-3
[19]	范洪伟, 王焕玲, 周宝桐, 译. 热病-桑福德抗微生物治疗指南. 第48版. 北京: 中国协和医科大学出版社, 2019.
[20]	GRUNDMANN H, GLASNER C, ALBIGER B, et al. Occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in the European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE): A prospective, multinational study. Lancet Infect Dis,2017,17(2): 153–163. DOI: 10.1016/S1473-3099(16)30257-2
[21]	KAZMIERCZAK K M, DE JONGE B L M, STONE G G, et al. In vitro activity of ceftazidime/avibactam against isolates of Enterobacteriaceae collected in European countries: INFORM global surveillance 2012-15. J Antimicrob Chemother,2018,73(10): 2782–2788. DOI: 10.1093/jac/dky266
[22]	DI BELLA S, GIACOBBE D R, MARAOLO A E, et al. Resistance to ceftazidime/avibactam in infections and colonisations by KPC-producing Enterobacterales: A systematic review of observational clinical studies. J Glob Antimicrob Resist,2021,25: 268–281. DOI: 10.1016/j.jgar.2021.04.001
[23]	TAN X, KIM H S, BAUGH K, et al. Therapeutic options for metallo-β-lactamase-producing Enterobacterales. Infect Drug Resist,2021,14: 125–142. DOI: 10.2147/IDR.S246174