- 1. School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang 330006, P. R. China;
- 2. Department of Nosocomial Infection Control, Jiangxi Children’s Hospital, Nanchang 330066, P. R. China;
In recent years, with the wide application of carbapenems, the resistance of Enterobacterium to carbapenems has become increasingly high, leading to a large number of carbapenem-resistant Klebsiella pneumoniae (CRKP). These bacteria are often resistant to many different types of antibacterial drugs, including carbapenems, which leads to clinical treatment failure and seriously threatens the life safety of patients. Currently, these bacteria have become an independent risk factor for patients’ death. This article reviews the drug resistance, infection status and influencing factors, and medication therapy of CRKP, in order to facilitate the clinical diagnosis, treatment, and disease process control of CRKP infection, and provide reference for curbing bacterial drug resistance.
Citation: TAN Shengtong, ZHANG Xinping, CHEN Xiuwen. Research progress on influencing factors of drug resistance of carbapenem-resistant Klebsiella pneumoniae. West China Medical Journal, 2023, 38(3): 459-464. doi: 10.7507/1002-0179.202302148 Copy
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- 2. 康蓓佩, 付晓蕊, 贺文芳, 等. 耐碳青霉烯类的肺炎克雷伯菌的感染特点及耐药基因分析. 国际检验医学杂志, 2019, 40(24): 2991-2994, 2998.
- 3. 杨沙沙, 王喜仁, 韩杰, 等. 美国 CLSI 抗菌药物敏感试验操作标准(2010 年版)部分变更内容. 中国感染控制杂志, 2010, 9(4): 303-304.
- 4. Logan LK, Weinstein RA. The epidemiology of carbapenem-resistant Enterobacteriaceae: the impact and evolution of a global menace. J Infect Dis, 2017, 215(Suppl_1): S28-S36.
- 5. Oteo J, Pérez-Vázquez M, Bautista V, et al. The spread of KPC-producing Enterobacteriaceae in Spain: WGS analysis of the emerging high-risk clones of Klebsiella pneumoniae ST11/KPC-2, ST101/KPC-2 and ST512/KPC-3. J Antimicrob Chemother, 2016, 71(12): 3392-3399.
- 6. Liao W, Liu Y, Zhang W. Virulence evolution, molecular mechanisms of resistance and prevalence of ST11 carbapenem-resistant Klebsiella pneumoniae in China: a review over the last 10 years. J Glob Antimicrob Resist, 2020, 23: 174-180.
- 7. Patel G, Bonomo RA. “Stormy waters ahead”: global emergence of carbapenemases. Front Microbiol, 2013, 4: 48.
- 8. 禹明均, 郑小鹏, 李春江. 耐碳青霉烯类肺炎克雷伯菌耐药机制的研究进展. 现代盐化工, 2022, 49(3): 13-15.
- 9. 许晓娜, 王志盛, 张小倩, 等. 耐碳青霉烯类肺炎克雷伯菌耐药机制的研究进展. 河南医学研究, 2018, 27(17): 3125-3126.
- 10. Ho PL, Cheung YY, Wang Y, et al. Characterization of carbapenem-resistant Escherichia coli and Klebsiella pneumoniae from a healthcare region in Hong Kong. Eur J Clin Microbiol Infect Dis, 2016, 35(3): 379-385.
- 11. 王芬芳, 杨坤祥, 徐华. 新生儿医院感染肺炎克雷伯菌的耐药性分析. 国际检验医学杂志, 2017, 38(1): 107-109.
- 12. 赵容陶, 娜木罕, 朝宝, 等. 新生儿肺炎克雷伯菌败血症的临床特征及耐药性分析. 中国妇幼健康研究, 2022, 33(6): 96-102.
- 13. 杜逸亭, 胡旭红, 杨晓荣, 等. 新生儿肺炎克雷伯菌败血症临床特点和药敏分析. 四川医学, 2017, 38(12): 1420-1423.
- 14. 2020 年全国细菌耐药监测报告. 中国合理用药探索, 2022, 19(11): 83.
- 15. 郝东侠, 王彦宏, 王旭东. 医院获得性耐碳青霉烯肺炎克雷伯杆菌感染的特点、危险因素分析及预后. 中国临床医生杂志, 2019, 47(5): 522-525.
- 16. Pellegrini JL, Aguirre C, Soto SM, et al. Colistin resistance in carbapenem-resistant Klebsiella pneumoniae isolates from a pediatric hospital from Corrientes, Argentina. Rev Chilena Infectol, 2022, 39(2): 109-116.
- 17. Candevir Ulu A, Güven Gökmen T, Kibar F, et al. Molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae at a Turkish centre: is the increase of resistance a threat for Europe?. J Glob Antimicrob Resist, 2017, 11: 10-16.
- 18. Ghamari M, Beigverdi R, Jabalameli F, et al. Antimicrobial resistance pattern, virulence determinants and molecular analysis of carbapenem-resistant Klebsiella pneumoniae isolated from clinical samples in Iran. FEMS Microbiol Lett, 2022, 369(1): fnac100.
- 19. Chen IR, Huang PH, Wu PF, et al. Clinical characteristics and outcomes of 56 patients with pneumonia caused by carbapenem-resistant Klebsiella pneumoniae. J Glob Antimicrob Resist, 2021, 25: 326-330.
- 20. Lee YL, Ko WC, Hsueh PR. Geographic patterns of global isolates of carbapenem-resistant Klebsiella pneumoniae and the activity of ceftazidime/avibactam, meropenem/vaborbactam, and comparators against these isolates: Results from the Antimicrobial Testing Leadership and Surveillance (ATLAS) program, 2020. Int J Antimicrob Agents, 2022, 60(5/6): 106679.
- 21. Tesfa T, Mitiku H, Edae M, et al. Prevalence and incidence of carbapenem-resistant K. pneumoniae colonization: systematic review and meta-analysis. Syst Rev, 2022, 11(1): 240.
- 22. Ahmed El-Domany R, El-Banna T, Sonbol F, et al. Co-existence of NDM-1 and OXA-48 genes in carbapenem resistant Klebsiella pneumoniae clinical isolates in Kafrelsheikh, Egypt. Afr Health Sci, 2021, 21(2): 489-496.
- 23. Thapa S, Adhikari N, Shah AK, et al. Detection of NDM-1 and VIM genes in carbapenem-resistant Klebsiella pneumoniae isolates from a tertiary health-care center in Kathmandu, Nepal. Chemotherapy, 2021, 66(5/6): 199-209.
- 24. Berglund B, Hoang NTB, Lundberg L, et al. Clonal spread of carbapenem-resistant Klebsiella pneumoniae among patients at admission and discharge at a Vietnamese neonatal intensive care unit. Antimicrob Resist Infect Control, 2021, 10(1): 162.
- 25. Falagas ME, Tansarli GS, Karageorgopoulos DE, et al. Deaths attributable to carbapenem-resistant Enterobacteriaceae infections. Emerg Infect Dis, 2014, 20(7): 1170-1175.
- 26. 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.
- 27. Paczosa MK, Mecsas J. Klebsiella pneumoniae: going on the offense with a strong defense. Microbiol Mol Biol Rev, 2016, 80(3): 629-661.
- 28. Martin RM, Bachman MA. Colonization, infection, and the accessory genome of Klebsiella pneumoniae. Front Cell Infect Microbiol, 2018, 8: 4.
- 29. Gomez-Simmonds A, Uhlemann AC. Clinical implications of genomic adaptation and evolution of carbapenem-resistant Klebsiella pneumoniae. J Infect Dis, 2017, 215(Suppl_1): S18-S27.
- 30. Arato V, Raso MM, Gasperini G, et al. Prophylaxis and treatment against Klebsiella pneumoniae: current insights on this emerging anti-microbial resistant global threat. Int J Mol Sci, 2021, 22(8): 4042.
- 31. Han R, Niu M, Liu S, et al. The effect of siderophore virulence genes entB and ybtS on the virulence of carbapenem-resistant Klebsiella pneumoniae. Microb Pathog, 2022, 171: 105746.
- 32. 于新桥. 早产儿败血症临床治疗中碳青霉烯类和 β-内酰胺类药物的使用与耐药性分析. 检验医学与临床, 2017, 14(7): 1021-1024.
- 33. Ruiz J, Gordon M, Villarreal E, et al. Influence of antibiotic pressure on multi-drug resistant Klebsiella pneumoniae colonisation in critically ill patients. Antimicrob Resist Infect Control, 2019, 8: 38.
- 34. Li M, Yang S, Yao H, et al. Retrospective analysis of epidemiology, risk factors, and outcomes of health care-acquired carbapenem-resistant Klebsiella pneumoniae bacteremia in a Chinese tertiary hospital, 2010-2019. Infect Dis Ther, 2023, 12(2): 473-485.
- 35. Qian Y, Bi Y, Liu S, et al. Predictors of mortality in patients with carbapenem-resistant Klebsiella pneumoniae infection: a meta-analysis and a systematic review. Ann Palliat Med, 2021, 10(7): 7340-7350.
- 36. Liu P, Li X, Luo M, et al. Risk factors for carbapenem-resistant Klebsiella pneumoniae infection: a meta-analysis. Microb Drug Resist, 2018, 24(2): 190-198.
- 37. Yuan Y, Wang J, Yao Z, et al. Risk Factors for carbapenem-Resistant Klebsiella pneumoniae bloodstream infections and outcomes. Infect Drug Resist, 2020, 13: 207-215.
- 38. Lu J, Zhang A, Han L, et al. Clinical outcomes and risk factors for death following carbapenem-resistant Klebsiella pneumoniae infection in solid organ transplant recipients. Microbiol Spectr, 2023, 11(1): e0475522.
- 39. Manandhar S, Amatya P, Ansari I, et al. Risk factors for the development of neonatal sepsis in a neonatal intensive care unit of a tertiary care hospital of Nepal. BMC Infect Dis, 2021, 21(1): 546.
- 40. Akgul F, Bozkurt I, Sunbul M, et al. Risk factors and mortality in the carbapenem-resistant Klebsiella pneumoniae infection: case control study. Pathog Glob Health, 2016, 110(7/8): 321-325.
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