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. Tängdén 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. 中华人民共和国卫生部医政司. 全国临床检验操作规程. 第 3 版. 南京: 东南大学出版社, 2006.
8. 胡付品, 郭燕, 朱德妹, 等. 2016 年中国 CHINET 细菌耐药性监测. 中国感染与化疗杂志, 2017, 17(5): 481-491.
9. 王云娟, 宋贵波, 苏艳丹, 等. 2013-2015 年云南省三级医院尿培养病原菌分布及耐药性分析. 中国抗生素杂志, 2017, 42(7): 548-560.
10. 植志全, 卓超, 苏丹虹, 等. 广州地区医院感染大肠埃希菌及肺炎克雷伯菌耐药性监测分析. 中华医院感染学杂志, 2012, 22(9): 1915-1917.
11. 崔畅, 朱卫民, 唐小红. 2010-2013 年我院肺炎克雷伯菌感染的临床及耐药分析. 中国抗生素杂志, 2015, 40(5): 372-376, 381.
12. 周海英, 许云敏, 余丽萍, 等. 2010-2013 年新生儿重症监护室肠杆菌科细菌耐药性变迁. 中国感染与化疗杂志, 2015, 15(5): 452-458.
13. 贾琴妹, 尹家丽. 多重耐药菌感染的分析及预防控制对策. 国际检验医学杂志, 2015, 36(15): 2183-2184, 2186.
14. 张渝, 邵天波, 陈瑞春, 等. 2013 年昆明某院临床分离致病菌的分布及耐药分析. 国际检验医学杂志, 2015, 36(11): 1565-1567, 1570.
15. 黄艳梅, 满宝华, 谭红丽. 云南省某大型综合医院临床病原菌的分布及耐药分析. 国际检验医学杂志, 2015, 36(7): 892-894.
16. 刘春林, 徐红云, 张志鹏, 等. 2009-2013 年肠球菌属临床感染及耐药性分析. 中国感染与化疗杂志, 2015, 15(2): 142-145.
17. 杜艳, 陈正辉, 陈瑞春, 等. 2012 年中国云南地区革兰阴性杆菌耐药监测. 中国抗生素杂志, 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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