Prevalence of Carbapenem-Resistant Klebsiella pneumoniae Infection in a Northern Province in China: Clinical Characteristics, Drug Resistance, and Geographic Distribution

Na Wang; Minghua Zhan; Jianhua Liu; Yao Wang; Yongwang Hou; Caiqing Li; Jia Li; Xuying Han; Jinlu Liu; Yong Chen; Jingjing Fan; Jianhua Tang; Wenhua Lu; Xinran Zhong; Zhihua Zhang; Wei Zhang

doi:10.2147/IDR.S347343

Prevalence of Carbapenem-Resistant Klebsiella pneumoniae Infection in a Northern Province in China: Clinical Characteristics, Drug Resistance, and Geographic Distribution

Infect Drug Resist. 2022 Feb 22:15:569-579. doi: 10.2147/IDR.S347343. eCollection 2022.

Authors

Na Wang¹, Minghua Zhan^{1

2}, Jianhua Liu³, Yao Wang⁴, Yongwang Hou⁵, Caiqing Li¹, Jia Li¹, Xuying Han¹, Jinlu Liu¹, Yong Chen⁶, Jingjing Fan⁶, Jianhua Tang⁷, Wenhua Lu⁸, Xinran Zhong¹, Zhihua Zhang³, Wei Zhang^{1

4}

Affiliations

¹ Microbiology Department, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, 075000, People's Republic of China.
² Clinical Laboratory, Peking University People's Hospital, Beijing, 100730, People's Republic of China.
³ Respiratory Department, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, 075000, People's Republic of China.
⁴ Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, People's Republic of China.
⁵ Clinical Laboratory, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, 075000, People's Republic of China.
⁶ Infectious Disease Department, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, 075000, People's Republic of China.
⁷ Clinical Pharmacy Department, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, 075000, People's Republic of China.
⁸ Dental Department, Beijing Fengtai Tieying Community Health Service Center, Beijing, 100730, People's Republic of China.

Abstract

Purpose: In this study, we analyzed the clinical distribution and drug resistance of carbapenem-resistant Klebsiella pneumoniae (CRKP) strains, the minimum inhibitory concentrations (MIC), MIC50 and MIC90, and geographical distribution in Hebei Province, China. We aimed to provide epidemiological research data, formulate appropriate combined treatment schemes, reasonably select antibiotics, and standardize nosocomial infection control schemes.

Patients and methods: A total of 6328 strains of CRKP were collected from 2017 to 2019. The MIC was determined for the drug sensitivity test, and the experimental data were statistically analyzed using WHONET5.6.

Results: The detection rate of CRKP increased annually from 13.4% in 2017 to 14.5% in 2018, and 14.6% in 2019. The ratio of males to females was approximately 2:1; 53.6% were elderly, 39% were adults, 4.8% were minors, and 2.5% were newborns. The specimens collected were mainly sputum (70.9%). The resistance rate of CRKP to carbapenems and other β-lactam antibiotics was found to be increasing, with resistance rates generally greater than 90%. The resistance rate to aminoglycoside antibiotics decreased yearly to approximately 50%, and the resistance rate to quinolones remained unchanged at approximately 80%. From 2017 to 2019, the resistance rate of CRKP in Hebei Province to various antibiotics was high, and the resistance rate to β-lactam antibiotics increased each year.

Conclusion: The situation of CRKP resistance is severe in Hebei Province, China. The resistance rate to most antibiotics is very high and shows an upward trend. Among them, the resistance rate to polymyxin is low; however, few resistant strains do exist. MIC50 and MIC90 are higher than their MICs. It mainly causes lung infection in elderly men. This study is helpful to improve the diagnosis, treatment, and prevention of CRKP infection in our province.

Keywords: Klebsiella pneumoniae; carbapenems; clinical distribution; drug resistance; geographic distribution; minimum inhibitory concentration.

Grants and funding

This work was supported by National Key R & D Plan Research on Standardized Diagnosis, Investigation and Treatment Technology System of New and Major Foodborne Diseases (2017YFC1601502), Scientific Research Fund Project of Hebei Provincial Health Commission (20180843, 20190904, and 20210702) and Key R&D project of Zhangjiakou City (2121098D, 2121064D).