Clinical characteristics and antibiotic resistance analysis of bloodstream infection caused by Klebsiella pneumoniae in the north of Henan province
Authors: Wang Yanchao , Wang Shanmei , Yan Wenjuan , Yuan Youhua , Yang Junzheng 
Published: June 2021

Objectives

To analyze clinical characteristics of bloodstream infection caused by Klebsiella pneumoniae and antibiotic resistance of Klebsiella pneumoniae in the north of Henan province, provide the basis for rational selection of antimicrobial drugs.

Methods

Klebsiella pneumoniae was isolated from 195 patients with bloodstream infection caused by Klebsiella pneumoniae in 2017 in the north of Henan Province, Phoenix100 blood culture and identification system were used for bacterial identification and drug sensitivity test was used for antibiotic resistance detection, and WHONET 5.6 software was used for data analysis of antibiotic resistance and antibiotic sensitivity; the medical history of patients, antibiotic use and laboratory examination results of 195 cases of patients with bloodstream infection caused by Klebsiella pneumoniae were also retrospectively analyzed.

Results

The patients with bloodstream infection caused by Klebsiella pneumoniae were mainly distributed in ICU, surgical department and Internal medicine department. There were 110 patients with bloodstream infection caused by Klebsiella pneumoniae accompanied with underlying diseases, accounting for 56.41% in 195 patients with bloodstream infection caused by Klebsiella pneumoniae, and 87 (87/110, 77.3%) patients accompanied with hypertension and diabetes. Drug sensitivity test showed that in 195 patients with bloodstream infection caused by Klebsiella pneumoniae, the top three antibiotics of the drug resistance rate of Klebsiella pneumoniae were cefazolin (74%), amoxicillin/clavulanic acid (70.1%), ampicillin /sulbactam (68.5%); the lower three antibiotics of drug resistance rate were imipenem (52%), cefepime (53%) and amikacin (33%); there were 81 strains of Klebsiella pneumoniae produced ESBLs, accounting for 41.53% in 195 strains of Klebsiella pneumoniae. The drug resistance rate of ESBLs positive strains was significantly higher than that of ESBL negative strains. It should be pointed out that the resistance of ESBLs positive strains of Klebsiella pneumoniae to cefazole reached 100%, followed by gentamicin (71.4%), ciprofloxacin (70.4%) and levofloxacin (69.1%); The resistance of ESBLs negative strains to cefazole was 18.2%, followed by gentamicin (3.5%), ciprofloxacin (3.0%) and levofloxacin (19.3%).

Conclusions

The number of total bacteria isolated from departments with large number of patients is relatively large, and the number of pneumonia patients caused by Klebsiella is also increased; ESBLs positive strains in this hospital are still the main reasons for the drug resistance of Klebsiella pneumoniae, reducing the antibiotics use of cefazol, gentamycin, ciprofloxacin and levofloxacin can effectively reduce the resistance of Klebsiella pneumoniae in the hospital. At the same time, we should pay attention to some contraindications for treating hypertension, diabetes drugs and antibiotics; the clinical staff should pay attention to the timely blood culture test, rational drug use can reduce the emergence of drug-resistant strains and prevent the outbreak of nosocomial infection.