Analysis Of Clinical Epidemiological Data Of Carbapenem-resistant Klebsiella Pneumoniae In Our Hospital From 2014 To 2018

Objective To investigate the detection of carbapenem-resistant Klebsiella pneumoniae and clinical characteristics of infected patients in a top three hospital in the past 5 years,and to provide evidence for clinical diagnosis and treatment.Methods The clinical isolates of Klebsiella pneumoniae from January 2014 to D ecember 2018 were collected and analyzed for the detection rate,specimen source distribution,department distribution,drug resistance and prognosis Factors and other clinical data of carbapenem-resistant Klebsiella pneumoniae.Results From January 2014 to December 2018,a total of 690 strains of carbapenemresistant Klebsiella were detected,with a detection rate of 14.29%,and the annual detection rates were 12.98%,13.06%,11.54%,and 15.30%,16.67%;The overall detection rate is increasing year by year;the top five specimen sources were from sputum 424 strains(61.3%),mid-stream urine 73 strains(10.58%),blood 56 strains(8.12%),incisional secretions 43 strains(6.23%)and catheters 19 strains(2.75%);carbapenemresistant Klebsiella pneumoniae from ICU has the highest proportion,276 strains(40.00%),followed by 58 strains(8.41%)in the respiratory department,44 strains(6.38%)in the urology department,39 strains(5.65%)in the burn department and 37 strains(5.36%)of neurosurgery.CRKP is highly resistant to most common antibacterials in clinical practice.Of the 16 antibiotics tested for drug sensitivity,11 antibiotics are resistant to > 77%.CRKP has relatively low resistance to amikacin,co-trimoxazole and minocycline,They are 51.10%,46.91% and 31.86% respectively.Among them,the resistance rates of CRKP to polymyxin and tigecycline reached 10.73% and 10.10%.There was a statistically significant difference between patients who failed to treat and patients who had responded to treatment with a combination of ≥3 basic diseases,suffering from diabetes,having malignant tumors,staying in ICU,mechanical ventilation,retaining catheterization,other aggressive procedures,and mixed infection(P<0.05);Patients who failed treatment and patients who were effective in treatment there was no significant difference in smoking,drinking,cardiovascular disease,nervous system disease,blood disease,chronic lung disease,chronic liver and kidney insufficiency,recent major surgery,multiple previous hospitalizations,or hospitalizations before this visit(P>0.05).Conclusion carbapenem-resistant Klebsiella pneumoniae infections have been increasing year by year,with the highest number of patients with carbapenem-resistant Klebsiella pneumoniae infections in ICU.Clinically,according to its possible prognostic factors,effective and feasible diagnosis and treatment and prevention and control measures should be taken to reduce the incidence of carbapenem-resistant Klebsiella infection.