Epidemiological characteristics of carbapenem-resistant Klebsiella pneumoniae infection in adult inpatients
10.3969/j.issn.1006-2483.2023.05.021
- VernacularTitle:成人住院患者耐碳青霉烯类肺炎克雷伯菌感染的流行病学特征
- Author:
Feng SHI
1
;
Haiyan GUO
1
Author Information
1. Department of Clinical Laboratory , Shanghai Ninth People's Hospital , Shanghai Jiao Tong University School of Medicine , Shanghai 201999 , China
- Publication Type:Journal Article
- Keywords:
Adult inpatients;
Carbapenem resistance;
Klebsiella pneumoniae;
Epidemiological characteristics
- From:
Journal of Public Health and Preventive Medicine
2023;34(5):95-98
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the epidemiological characteristics of carbapenem-resistant Klebsiella pneumoniae (CRKP) in adult inpatients, and to provide a theoretical basis for the diagnosis and treatment of CRKP. Methods A total of 753 hospitalized patients with Klebsiella pneumoniae (KPN) infection in our hospital from 2017 to 2021 were selected as the investigation subjects. According to the sensitivity to carbapenem drugs, the patients were divided into carbapenem sensitive Klebsiella pneumoniae (CSKP) group (n=638) and CRKP group (n=115). The age, gender, department distribution, underlying diseases, length of hospital stay, use of antibiotics and other clinical data of all subjects were analyzed by self-made survey scale of our hospital. Univariate analysis and logistic regression analysis were used to analyze the risk factors of CRKP nosocomial infection in adult inpatients. Results Among of 753 KPN patients, 115 cases (15.27%) were detected with CRKP, including 87 males and 28 females. The detection rate of CRKP in different age groups was significantly different (P<0.05). The detection rate of CRKP in the age group of >60 years was significantly higher than that in the age group of 41-60 years, 21-40 years, and 16-20 years (P<0.05). The detection rate of CRKP increased year by year from 2017 to 2021, and the difference was statistically significant (P<0.05). There was no significant difference between the detection rate of CRKP in spring and winter (66/459) and that in summer and autumn (49/294) (χ2 value =0.725, P>0.05). CRKP strains were mainly isolated from oral and maxillofacial surgery (19.13%), infection department (15.65%), geriatric department (15.65%), and ICU (14.78%). The detection rate of CRKP in different pathogenic bacteria samples was different, including sputum (19.40%), urine (15.43%) and blood (12.58%), with statistically significant difference (P<0.05) The respiratory tract sputum specimens were all expectoration. There were significant differences in age, gender, use of carbapenems ≥7 days, invasive procedures, use of antibiotics ≥2 kinds, use of antibiotics ≥14 days, and use of enzyme inhibitors ≥7 days between the CSKP group and the CRKP group (P<0.05). Antimicrobial application time ≥14 days (OR=5.412), invasive operation (OR=6.431), and carbapenem use ≥7 days (OR=5.417) were the risk factors for CRKP nosocomial infection in adult inpatients (P<0.05). Conclusion Nosocomial infection of CRKP occurs mostly in elderly ICU patients. Intervention measures should be given to adult inpatients who have used antibiotics for ≥14 days, invasive procedures, and carbapenem antibiotics for ≥7 days, which can reduce the risk of CRKP infection in inpatients.
