Changes in antimicrobial resistance rates of Klebsiella pneumoniae in in-tensive care unit and comparison between Chinese and foreign databases
10.12138/j.issn.1671-9638.20246131
- VernacularTitle:重症医学科肺炎克雷伯菌耐药率变迁及中外数据库对比
- Author:
Cheng-Yi FENG
1
;
Li-Wei ZHANG
;
Yang-Yang WANG
;
Shu-Fang JIANG
;
Jia DI
;
Jin-Nuo FAN
Author Information
1. 常州市第一人民医院感染管理处,江苏常州 213000
- Keywords:
Klebsiella pneumoniae;
MIMIC-Ⅳ database;
intensive care unit;
specimen distribution;
antimicro-bial resistance change
- From:
Chinese Journal of Infection Control
2024;23(10):1241-1248
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the detection rates and antimicrobial resistance rates of Klebsiella pneumoniae(KP)between the intensive care unit of The First People's Hospital of Changzhou(CZFPH-ICU)and the American Medical Information Mart for Intensive Care-Ⅳ(MIMIC-Ⅳ),as well as the changes in the antimicrobial resistance rate of KP and detection rate of carbapenem-resistant KP(CRKP)in CZFPH-ICU.Methods Differences in speci-men distribution and antimicrobial resistance rate of KP detected from CZFPH-ICU and MIMIC-Ⅳ from 2017 to 2019,as well as the changing trends of specimen distribution,antimicrobial resistance rate,detection rates of KP and CRKP from different specimen sources in CZFPH-ICU from 2017 to 2023 were retrospectively analyzed.Results A total of 2 434 strains of KP were detected in CZFPH-ICU from 2017 to 2019,mainly from sputum specimens.A total of 1 137 strains of KP were detected from MIMIC-Ⅳ database,mainly from urine specimens.Compared with MIMIC-Ⅳ,KP detected from CZFPH-ICU showed higher resistance rate to commonly used antimicrobial agents.A total of 4 874 strains of KP were detected from CZFPH-ICU from 2020 to 2023,mainly from sputum specimens.The detection rates of CRKP from sputum,urine,drainage fluid and bile specimens decreased from 17.77%,20.15%,24.22%and 24.07%in 2017-2019 to 12.99%,13.56%,13.63%and 8.00%in 2020-2023,respectively(all P<0.05).The changing trend of resistance rate of KP isolated from CZFPH-ICU from 2017 to 2023 to commonly used antimicrobial agents such as piperacillin/tazobactam,imipenem,and meropenem increased in 2017-2019,decreased in 2020-2022,and slightly increased in 2023.In 2013,the resistance rates of KP isolated from CZFPH-ICU to ceftazidime/avibactam,polycolistin B and tigacycline were 21.28%,10.22%and 7.03%,respectively.Conclusion In recent 7 years,resistance rate of KP from CZFPH-ICU showed a slow decline trend,but it was still higher than that in foreign MIMIC-Ⅳ database.Hospitals should strengthen various infection prevention and control measures to ef-fectively control KP resistance and infection.