| Objective:In recent years,the clinical isolation rate of Klebsiella pneumoniae showed a continuous upward trend,the level of drug resistance also showed a continuous upward trend,Carbapenem resistant Klebsiella pneumoniae and multi-drug resistance Klebsiella pneumoniae have emerged,which has increased the difficulty of clinical treatment and aggravated the disease burden of patients,KP poses a threat to public health security worldwide.By analyzing the monitoring data of the KP clinical isolates in Jilin province,to understand the general situation,drug resistance and the carrying situation of related genes of KP,and to analyze the coincidence between the drug resistance phenotype and the resistant genes,so as to raise the attention of medical staff to the importance of KP,to provide references for preventing the spread of drug-resistant dominant strains of KP,guiding the rational use of clinical drugs and controlling of hospital infection.Methods:The source information,drug sensitivity results,drug resistance genes of KP in 9 cities in Jilin Province from March 2019 to January 2022 were all from the Chinese Pathogen Identification Net.A total of 473 strains were included in the study after excluding the strains lacking information such as drug sensitivity results,drug resistance genes etc.It mainly described the source information of the strains,the durg resistance and type of 8 categories and 17 kinds,including β-lactamase,Aminoglycoside,etc.And describing the detection rate of 18 kinds of the drug resistance genes,and calculating the coincidence of drug resistance phenotype and drug resistance genes.IBM SPSS Statistics 24.0 statistical software was used for data analysis.The counting data was described by rate or constituent ratio,and the comparison between groups was performed by Chi-square test or Fisher exact probability method.P<0.05 was considered that the difference was statistically significant.Results:1.Source information of 473 KP strains:there were 362(76.53%)sputum samples,22(4.65%)urine samples,21(4.44%)blood samples,27(5.71%)faecal samples,and 41(8.67%)other samples;there are 86(18.18%)cases in Changchun,80(16.91%)cases in Siping,75(15.86%)cases in Liaoyuan,64(13.53%)cases in Songyuan,51(10.79%)cases in Baishan,50(10.57%)cases in Tonghua,28(5.92%)cases in Jilin,23(4.86%)cases in Baicheng,and 16(3.38%)cases in Yanbian.2.Drug resistance of 473 KP strains(1)Drug resistance of strains to 8 categories and 17 kinds antibiotics:the overall drug resistance rate was 91.54%.The resistance rates of KP to 8 categories of antibiotics were β-lactamase 79.70%,macrolides 53.49%,tetracyclines 37.84%,quinolones 37.21%,aminoglycosides 29.60%,sulfonamides 29.18%,chloramphenicols 25.79%,peptide drugs 3.17%.Among the 17 antibiotics,the drug resistance rate of the strains to ampicillin was highest(79.49%),followed by azithromycin(53.49%);the rates of colistin,meropenem and amikacin were all lower than 10%.No strain was resistant to tigecycline and ceftazidime/avibactam.(2)Drug resistance of different drug resistance types:the single drug resistance rate was 27.48%,the double drug resistance rate was 18.18%,and the multi-drug resistance rate was 45.88%.Among single drug resistant strains,the resistance rate ofβ-lactamase was 18.18%,peptide drugs 8.88%,macrolides 0.42%.The number of double drug resistanc strains to β-lactamase and macrolides was the highest(11.84%).In multi-drug resistant strains,the drug resistance rate of 7 kinds of antibiotic resistant strains including β-lactamase,aminoglycosides,quinolones,tetracyclines,chloramphenicols,sulfonamides and macrolides,which was highest(5.50%).(3)Drug resistance of CRKP:there were 65 CRKP and 408 non-CRKP.There were 63(96.92%)multi-drug resistant strains and 2(3.08%)double drug resistant strains in CRKP.The drug resistance rates of CRKP to ampicillin,ampicillin-sulbactam,cefotaxime,ceftazidime,and ciprofloxacin were all above 80.00%,while the drug resistance rates to tetracycline,nalicixic acid,and amikacin were all above 50.00%.In addition,the drug resistance rates of CRKP were higher than that of non-CRKP(P<0.05).3.Related information on drug resistance genes of 473 KP strains:the detection rate of β-lactamase resistant gene blaSHV was highest(95.35%),while the detection rate of other resistant genes ranged from 1.69%to 32.35%.The genotypes of 39 strains carrying the blaKPC gene were all blaKPC-2 subtypes,and 8 strains carrying the blaNDM gene were multi-drug resistant strains and CRKP,among which a strain was blaNDM-1 subtype.The coincidence rates between β-lactamase resistance phenotypes and blaSHV resistance gene were above 90.00%,further the coincidence rate between meropenem resistance phenotype and blaSHV was 100.00%.Conclusions:1.The drug resistance rate of Klebsiella pneumoniae in Jilin Province was high.It was generally resistant to commonly used antibiotics,and the drug resistance rate of strains to β-lactamase antibiotics was the highest.No strain was resistant to tigecyclin and ceftazidime/avibactam.There were single,double,and multi-drug resistant strains.The drug resistance of CRKP was serious.2.The detection rate of blaSHV was the highest.The blaKPC subtype was blaKPC-2.The strains carrying blaNDM gene were multi-drug resistant strains and CRKP,one of which was blaNDM-1 subtype.The coincidence situation between theβ-lactamase resistance phenotype and the blaSHV gene was found. |
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