Prevalence of Carbapenem-Resistant Klebsiella pneumoniae Infection in a Northern Province in China: Clinical Characteristics, Drug Resistance, and Geographic Distribution

Abstract

Purpose

In this study, we analyzed the clinical distribution and drug resistance of carbapenem-resistant Klebsiella pneumoniae (CRKP) strains, the minimum inhibitory concentrations (MIC), MIC50 and MIC90, and geographical distribution in Hebei Province, China. We aimed to provide epidemiological research data, formulate appropriate combined treatment schemes, reasonably select antibiotics, and standardize nosocomial infection control schemes.

Patients and Methods

A total of 6328 strains of CRKP were collected from 2017 to 2019. The MIC was determined for the drug sensitivity test, and the experimental data were statistically analyzed using WHONET5.6.

Results

The detection rate of CRKP increased annually from 13.4% in 2017 to 14.5% in 2018, and 14.6% in 2019. The ratio of males to females was approximately 2:1; 53.6% were elderly, 39% were adults, 4.8% were minors, and 2.5% were newborns. The specimens collected were mainly sputum (70.9%). The resistance rate of CRKP to carbapenems and other β-lactam antibiotics was found to be increasing, with resistance rates generally greater than 90%. The resistance rate to aminoglycoside antibiotics decreased yearly to approximately 50%, and the resistance rate to quinolones remained unchanged at approximately 80%. From 2017 to 2019, the resistance rate of CRKP in Hebei Province to various antibiotics was high, and the resistance rate to β-lactam antibiotics increased each year.

Conclusion

The situation of CRKP resistance is severe in Hebei Province, China. The resistance rate to most antibiotics is very high and shows an upward trend. Among them, the resistance rate to polymyxin is low; however, few resistant strains do exist. MIC50 and MIC90 are higher than their MICs. It mainly causes lung infection in elderly men. This study is helpful to improve the diagnosis, treatment, and prevention of CRKP infection in our province.

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© 2022 Wang et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commerical (unported, v3.0) License. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

Keywords:

• carbapenems
• clinical distribution
• drug resistance
• minimum inhibitory concentration
• geographic distribution
• Klebsiella pneumoniae

Data Sharing Statement

The data used and/or analyzed in this study are available from the corresponding author on reasonable request.

Ethics Approval and Informed Consent

The protocol has been reviewed by the Ethics Committee (IRB) of the First Affiliated Hospital of Hebei North University. As this was an observational study and strains cultured from residual samples were used in clinical diagnosis, the confidentiality of patient data is preserved and compliance with the Declaration of Helsinki is ensured. As the data did not affect patient care, the exemption criteria were met. After consulting the IRB of the First Affiliated Hospital of Hebei North University, a formal ethical review approval was obtained; written informed consent from the patient was not required (ethical approval no.: K2019147).

Acknowledgments

We thank Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College and Clinical Laboratory, and Laboratory of Peking University People’s Hospital for administrative and technical support. Many thanks to graduate students Zhan Xuli, Yue Weiye, Si Liyan, Yang Zhicong, Li Jingqi and Wang Yuandi for their contributions to the preservation of strains. The author thanks Editage (www.editage.cn) for English language editing.

Author Contributions

All authors contributed to data analysis, drafting or revising the article, have agreed on the journal to which the article will be submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in relation to this study.

Additional information

Funding

This work was supported by National Key R & D Plan Research on Standardized Diagnosis, Investigation and Treatment Technology System of New and Major Foodborne Diseases (2017YFC1601502), Scientific Research Fund Project of Hebei Provincial Health Commission (20180843, 20190904, and 20210702) and Key R&D project of Zhangjiakou City (2121098D, 2121064D).