Analysis of Drug Resistance Genotype and Distribution in Klebsiella pneumoniae Isolates from a Tertiary-Care Hospital in Guilin, China

Abstract

Purpose To better understand the distribution and drug resistance of Klebsiella pneumoniae and provide a basis for clinical treatment. Methods We studied 167 Klebsiella pneumoniae clinical specimens in the Second Affiliated Hospital of Guilin Medical University from November 2020 to June 2022. These clinical specimens were isolated from urine, blood, sputum, catheter, pus, drainage fluid, bile, joint fluid, alveolar lavage fluid, and wound/trauma/incision secretions were collected. The drug resistance of Klebsiella pneumoniae and clinical outcomes were analyzed. We designed primers based on relevant resistance genes in The Comprehensive Antibiotic Resistance Database, while a part of them also used primer sequences from the relevant literature. We detected the carbapenems gene using polymerase chain reaction (PCR) and sent the product to the company for sequencing and homology analysis. Results A total of 707 inpatients were recruited and 167 isolates of Klebsiella pneumoniae were obtained. 83 strains from sputum specimens (49.7%), 18 strains from wound/trauma/incision secretion specimens (10.8%), 15 strains from pus specimens (9.0%), and other strains from urine specimens, blood specimens, drainage fluid, bile specimens, bile specimens, catheter specimens, and joint fluid specimens (30.5%). Klebsiella pneumoniae has a high rate of resistance to ampicillin (AMP) (98.2%), tetracycline (TE) (36.5%), piperacillin (PIP) (36.5%), chloramphenicol (CHL) (35.3%), and cefazolin (CFZ) (33.5%). From the analysis of sequencing results, we found that 68 strains were missing membrane pore protein Ompk-35, 3 strains were detected carrying KPC-1/KPC-2 type, 12 strains were missing membrane pore protein Ompk-36, 62 strains were missing membrane pore protein Ompk-37, 1 strain was detected carrying NDM-1, and no VIM-1, IMP-4, OXA-48, SME-2. Conclusions Klebsiella pneumoniae mainly causes respiratory tract infections and has a high rate of resistance to cephalosporins, piperacillin, and other antibacterial drugs. The detection rate of missing membrane pore protein ompk-35/ompk-37 is high, and the more drug resistance gene species it carries, the more drug resistant drug species it is.