Drug resistance and clinical distribution of <i>Klebsiella pneumoniae</i> from May 2016 to May 2017 in the area of the Bai nationality_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

YANG min ¹ , DING Yibo ² , LI Liuqin ³ ,  WANG Peng ²

1. Department of Respiratory Medicine, First People’s Hospital of Dali, Dali, Yunnan 671000, P. R. China;
2. Yunnan Provincial Key Laboratory for Zoonosis Disease Control and Prevention, Yunnan Institute for Endemic Diseases Control and Prevention, Dali, Yunnan 671000, P. R. China;
3. Clinical Laboratory Department, First People’s Hospital of Dali, Dali, Yunnan 671000, P. R. China;

Corresponding?author：

WANG Peng, Email: wp030801@126.com

Keywords：

Klebsiella pneumoniae; Drug resistance distribution; Bai nationality

DOI：

10.7507/1671-6205.201804035

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Objective To retrospectively analyze antibiotic resistance and clinical characteristics of Klebsiella pneumoniae strains for guiding the rational use of antibiotics in the area of the Bai nationality.Methods The antibiotic resistance and clinical characteristics of Klebsiella pneumoniae strains were retrospective analyzed, which were isolated from specimens of inpatients in First People’s Hospital of Dali between May 2016 and May 2017.Results Among the 1 342 samples of various kinds of samples, 262 strains of Klebsiella pneumoniae were isolated, with the detection rate of 19.52% (262/1342). Clinical isolated strains were mainly from the new pediatric, intensive care unit, respiratory medicine, pediatrics, and mostly from sputum specimens (78.24%, 205/262). By screening of 22 kinds of antimicrobial agents, all strains had ampicillin resistance (100.00%), while none of these strains had ertapenem resistance. Extended-spectrum β-lactamases (ESBLs) positive strains’ resistance rate was higher than ESBLs negative strains (χ²=261.992, P<0.01). There were 76 drug resistant profiles, most of which were multidrug-resistant bacteria except 116 (44.27%) strains were resistant to ampicillin antibiotics only. And the number of strains in other resistant types ranged from 1 to 16. Only one of 262 strains had amikacin resistance, two of them were resistant to imipenem and meroenan.Conclusions There are many multidrug-resistant bacteria in Klebsiella pneumoniae in the population of Bai nationality, and there are no extensively drug resistant bacteria and pandrug-resistant bacteria strains. The strains of carbapene-resistant antibiotics should be worthy of clinical attention.

Citation： YANG min, DING Yibo, LI Liuqin, WANG Peng. Drug resistance and clinical distribution of Klebsiella pneumoniae from May 2016 to May 2017 in the area of the Bai nationality. Chinese Journal of Respiratory and Critical Care Medicine, 2019, 18(1): 15-20. doi: 10.7507/1671-6205.201804035 Copy

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1. T?ngdén T, Giske CG. Global dissemination of extensively drug-resistant carbapenemase-producing Enterobacteriaceae: clinical perspectives on detection, treatment and infection control. J Intern Med, 2015, 277(5): 501-512.
2. Prestinaci F, Pezzotti P, Pantosti A, et al. Antimicrobial resistance: a global multifaceted phenomenon. Pathog Glob Health, 2015, 109(7): 309-318.
3. Zhang Y, Zeng J, Liu W, et al. Emergence of a hypervirulent carbapenem-resistant Klebsiella pneumoniae isolate from clinical infections in China. J Infect, 2015, 71(5): 553-560.
4. Zhang R, Lin D, Chan EW, et al. Emergence of carbapenem-resistant serotype K1 hypervirulent Klebsiella pneumoniae strains in China. Antimicrob Agents Chemother, 2015, 60(1): 709-711.
5. Yong D, Toleman MA, Giske CG, et al. Characterization of a new metallo-β-lactamase gene, blaNDM-1, and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India. Antimicrob Agents Chemother, 2009, 53(12): 5046-5054.
6. Johnson AP, Woodford N. Global spread of antibiotic resistance: the example of New Delhi metallo-beta-lactamase (NDM)- mediated carbapenem resistance. Med Microbiol, 2013, 62(Pt 4): 499-513.
7. 中華人民共和國衛生部醫政司. 全國臨床檢驗操作規程. 第 3 版. 南京: 東南大學出版社, 2006.
8. 胡付品, 郭燕, 朱德妹, 等. 2016 年中國 CHINET 細菌耐藥性監測. 中國感染與化療雜志, 2017, 17(5): 481-491.
9. 王云娟, 宋貴波, 蘇艷丹, 等. 2013-2015 年云南省三級醫院尿培養病原菌分布及耐藥性分析. 中國抗生素雜志, 2017, 42(7): 548-560.
10. 植志全, 卓超, 蘇丹虹, 等. 廣州地區醫院感染大腸埃希菌及肺炎克雷伯菌耐藥性監測分析. 中華醫院感染學雜志, 2012, 22(9): 1915-1917.
11. 崔暢, 朱衛民, 唐小紅. 2010-2013 年我院肺炎克雷伯菌感染的臨床及耐藥分析. 中國抗生素雜志, 2015, 40(5): 372-376, 381.
12. 周海英, 許云敏, 余麗萍, 等. 2010-2013 年新生兒重癥監護室腸桿菌科細菌耐藥性變遷. 中國感染與化療雜志, 2015, 15(5): 452-458.
13. 賈琴妹, 尹家麗. 多重耐藥菌感染的分析及預防控制對策. 國際檢驗醫學雜志, 2015, 36(15): 2183-2184, 2186.
14. 張渝, 邵天波, 陳瑞春, 等. 2013 年昆明某院臨床分離致病菌的分布及耐藥分析. 國際檢驗醫學雜志, 2015, 36(11): 1565-1567, 1570.
15. 黃艷梅, 滿寶華, 譚紅麗. 云南省某大型綜合醫院臨床病原菌的分布及耐藥分析. 國際檢驗醫學雜志, 2015, 36(7): 892-894.
16. 劉春林, 徐紅云, 張志鵬, 等. 2009-2013 年腸球菌屬臨床感染及耐藥性分析. 中國感染與化療雜志, 2015, 15(2): 142-145.
17. 杜艷, 陳正輝, 陳瑞春, 等. 2012 年中國云南地區革蘭陰性桿菌耐藥監測. 中國抗生素雜志, 2014, 39(8): 629-634.
18. Li B, Yi Y, Wang Q, et al. Analysis of drug resistance determinants in Klebsiella pneumoniae isolates from a tertiary-care hospital in Beijing, China. PLoS One, 2012, 7(7): e42280.
19. Marchaim D, Gottesman T, Schwartz O, et al. National multicenter study of predictors and outcomes of bacteremia upon hospital admission caused by Enterobacteriaceae producing extended-spectrum beta-lactamases. Antimicrob Agents Chemother, 2010, 54(12): 5099-5104.
20. Lautenbach E, Patel JB, Bilker WB, et al. Extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae: risk factors for infection and impact of resistance on outcomes. Clin Infect Dis, 2001, 32(8): 1162-1171.
21. Ma L, Lin CJ, Chen JH, et al. Widespread dissemination of aminoglycoside resistance genes armA and rmtB in Klebsiella pneumonia isolates in Taiwan producing CTX-M-type extended-spectrum β-lactamases. Antimicrob Agents Chemother, 2009, 53(1): 104-111.

Chinese Journal of Respiratory and Critical Care Medicine

Drug resistance and clinical distribution of Klebsiella pneumoniae from May 2016 to May 2017 in the area of the Bai nationality

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