A 7-year surveillance of the drug resistance in Klebsiella pneumoniae from a primary health care center

Abstract

BackgroundThe increased prevalence of Klebsiella pneumoniae infections and resistance rates are a current cause for concern. However, data for resistance rates in K. pneumoniae strains from primary hospitals and the resistance distribution among the different isolate sample sources are scarce.MethodsAll the K. pneumoniae strains were isolated from patients who visited a primary health care center located in Central Zhejiang Province from January 2011 to December 2017. The specimens included blood, sputum, cervical secretions and urine. The species were identified by the Vitek 2 Compact Bacterial Identification and Monitoring System or VITEK-MS and the extended spectrum β-lactamase (ESBL) and drug resistance profiles were identified using the AST-GN13 Gram negative susceptibility card (VITEK-2). The genotype of strains from urine sources was analyzed by detecting TEM and SHV genes. Finally, the drug resistance rates among the isolates from different sample sources were analyzed using the Chi square test with SPSS software.ResultsA total of 5319 K. pneumoniae strains were isolated in this study. Among the 20 antimicrobial drugs studied, the resistance rates of K. pneumoniae strains varied from 1.4% (ertapenem) to 23.1% (nitrofurantoin). The antibiotic resistance rates varied significantly among the isolate samples sources for all, with the highest rates for all antibiotics except for nitrofurantoin found in urine samples. In addition, the ESBL-positive rate in urine samples was 27.1%, significantly higher than that of cervical secretions (20.2%), blood (16.5%) and sputum (15.2%). Compared to the ESBL-negative strains, higher resistance rates were detected in the ESBL-positive strains. The most common genotype of isolates from urine was SHV (28%, 23/82), following by TEM (14.6%, 12/82).ConclusionThe highest resistance rates of K. pneumoniae strains to most antibiotics found in urine samples are partly due to the ESBLs, indicating that a special attention should be paid in the treatment of urinary tract infection.

Prevalence, risk factors and molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae in patients from Zhejiang, China, 2008–2018

“…Among the different specimen types examined in this study, our results showed that K. pneumoniae isolates from urine were much more likely to be carbapenem-resistant than those isolated from sputum or blood. Although studies examining risk factors associated with CRKP carriage are limited, one study of ESBL-producing K. pneumoniae demonstrated that the isolation rate of ESBL-positive isolates from urine samples was significantly higher than those from blood and sputum [17].…”

Long Term Characteristics of Clinical Distribution and Resistance Trends of Carbapenem-Resistant and Extended-Spectrum β-Lactamase Klebsiella pneumoniae Infections: 2014–2022

“…19 The incidence of urinary tract infections caused by ESBL-KP has steadily increased in the US, and it has been shown that KP isolates from blood and urine are more carbapenem-resistant than sputum culture isolates. 17,20 In this study, CRKP patients were mainly concentrated in the population aged ≥70 years (80.9%) and neonates <1 year (16.2%). In addition, age over 70 years old was shown as a risk factor for CRKP and ESBL-KP infection.…”

Genomic Analysis of Carbapenemase-Producing Extensively Drug-Resistant Klebsiella pneumoniae Isolates Reveals the Horizontal Spread of p18-43_01 Plasmid Encoding blaNDM-1 in South Africa

“…However, the finding was comparable to a study in the tertiary hospital in Korea by Kang et al [52], where a CRE carriage rate on admission in 833 adults was 2.8%. Similarly, less than 2% CRKP was recorded in 7-year surveillance study in a primary health care centre in China [53]. However, in Brazil, a 6.8% CRE colonization rate has been reported on admission [54].…”