Purpose: Through long-term and large sample size statistical analysis, we revealed the pattern of Klebsiella pneumoniae (KP) infection and drug resistance and provided epidemiological data for the treatment and prevention and control of multidrug-resistant bacterial infection in our hospital.
Patients and Methods: Strains were identified using the BD Phoenix^TM 100 system, minimal inhibitory concentration of antibiotics were determined by the broth method, and data were statistically analyzed using WHONET 5.6 and SPSS27.0.
Results: The isolation rate of KP from Enterobacteriaceae (26.2%, 4547/17358) in our hospital showed an increasing annual trend, ranking second only to Escherichia coli. Carbapenem-resistant KP (CRKP) accounted for the highest proportion of carbapenem-resistant Enterobacteriaceae (72.2%, 431/597), showing an upward trend. Infected patients had a male-to-female ratio of approximately 2:1 and were mainly > 60 years of age (66.2%), with intensive care units being the most commonly distributed department. Sputum was the most common specimen type (74.0%). Compared with spring and summer, autumn and winter were the main epidemic seasons for KP and extended-spectrum β-lactamase KP (ESBL-KP). The resistance rate of KP to common antibiotics was low, but all showed an increasing trend each year. ESBL-KP was > 90% resistant to piperacillin, amoxicillin/clavulanic acid, and cefotaxime and less resistant to other common antibiotics, but showed an increasing trend in resistance to most antibiotics. CRKP resistance to common antibiotics was high, with resistance rates > 90%, excluding amikacin (64.1%), gentamicin (87.4%), cotrimoxazole (44.3%), chloramphenicol (13.6%), and tetracycline (30.5%).
Conclusion: KP in our hospital mainly caused pulmonary infection in older men, which occurred frequently in autumn and winter, and the isolation and drug resistance rates showed an increasing trend. Age over 70 years, admission to intensive care unit, and urinary tract infection were found to be the risk factors for CRKP and ESBL-KP-resistance.

Keywords: Klebsiella pneumoniae, antibacterial drugs, resistance trends, carbapenem-resistant, extended-spectrum β-lactamase, antimicrobial susceptibility surveillance


中文翻译：

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碳青霉烯耐药和超广谱 β-内酰胺酶肺炎克雷伯菌感染的临床分布和耐药趋势的长期特征：2014-2022

目的：通过长期大样本统计分析，揭示肺炎克雷伯菌（KP）感染及耐药规律，为我院多重耐药菌感染的救治和防控提供流行病学资料。
患者和方法：使用BD Phoenix ^TM 100系统鉴定菌株，通过肉汤法测定抗生素的最小抑菌浓度，并使用WHONET 5.6和SPSS27.0对数据进行统计分析。
结果：我院肠杆菌科KP分离率（26.2%，4547/17358）呈逐年上升趋势，仅次于大肠杆菌. 耐碳青霉烯类KP（CRKP）在耐碳青霉烯类肠杆菌中所占比例最高（72.2%，431/597），呈上升趋势。感染患者男女比例约为2:1，年龄>60岁（66.2%）的患者主要分布在重症监护病房。痰是最常见的标本类型 (74.0%)。与春季和夏季相比，秋季和冬季是KP和超广谱β-内酰胺酶KP（ESBL-KP）的主要流行季节。KP对常用抗生素的耐药率较低，但均呈逐年上升趋势。ESBL-KP对哌拉西林、阿莫西林/克拉维酸和头孢噻肟的耐药率> 90%，对其他常见抗生素的耐药性较低，但对大多数抗生素的耐药性呈上升趋势。
结论：我院KP以老年男性肺部感染为主，秋冬季多发，且分离率和耐药率呈上升趋势。年龄超过 70 岁、入住重症监护室和尿路感染被发现是 CRKP 和 ESBL-KP 耐药的危险因素。

关键词： 肺炎克雷伯菌，抗菌药物，耐药趋势，碳青霉烯类耐药，广谱β-内酰胺酶，药敏监测