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

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Table 1 Distribution Characteristics of CRKP Specimens from 2017 to 2019

Specimen Type	2017 (n = 1516)		2018 (n = 2249)		2019 (n = 2477)		Total
	N	P (%)	N	P (%)	N	P (%)	N	P (%)
Sputum	1044	68.87	1701	75.63	1738	70.17	4483	70.84
Urine	172	11.35	196	8.71	232	9.37	600	9.48
Blood	93	6.13	124	5.51	138	5.57	355	5.61
Secretion	38	2.51	60	2.67	90	3.63	188	2.97
Ascites	19	1.25	25	1.11	28	1.13	72	1.14
Balf	11	0.73	12	0.53	29	1.17	52	0.82
Bile	12	0.79	16	0.71	20	0.81	48	0.76
Fine needle aspiration	2	0.13	17	0.76	23	0.93	42	0.66
Pus	20	1.32	6	0.27	14	0.57	40	0.63
Drainage	3	0.20	14	0.62	14	0.57	31	0.49
Excreta	10	0.66	21	0.93	11	0.44	42	0.66
Hydrothorax	8	0.53	15	0.67	11	0.44	34	0.54
Other	84	5.54	128	5.48	129	5.21	341	5.39
Total	1516	100	2335	100	2477	100	6328	100.00

Abbreviations: N, number; P, proportion.

Table 2 Regional Distribution of CRKP in Hebei Province from 2017 to 2019

Territory Name	Year			Total	Proportion (%)
	2017(N)	2018(N)	2019(N)
Shijiazhuang	891	991	893	2775	43.85
Tangshan	189	525	554	1268	20.04
Cangzhou	76	287	280	643	10.16
Qinhuangdao	89	167	180	436	6.89
Xingtai	94	82	128	304	4.80
Handan	46	66	120	232	3.67
Zhangjiakou	25	110	88	223	3.52
Baoding	63	49	87	199	3.14
Chengteh	22	41	99	162	2.56
Langfang	21	17	48	86	1.36
Total	1516	2335	2477	6328	100.00

Abbreviation: N, number.

Figure 1 Overall distribution characteristics of carbapenem-resistant Klebsiella pneumoniae (CRKP). (A) Gender distribution characteristics of CRKP. (B) Age distribution characteristics of CRKP. (C) Distribution characteristics of CRKP departments.

Table 3 Drug Sensitivity Data of CRKP to Various Antibacterial Drugs from 2017 to 2019

Antibiotic Name	2017			2018			2019			Average Value
	N	R(%)	S(%)	N	R(%)	S(%)	N	R(%)	S(%)	N	R (%)	S (%)
Amoxicillin/clavulanic acid	322	80.1	16.8	474	94.9	4.2	593	97.5	1.7	1389	90.8	7.6
Cefotaxime	551	90.4	9.1	809	96.2	3.8	561	95.5	4.1	1921	94.0	5.7
Cefoxitin	647	81.6	15.3	1033	85	10.4	1028	87.2	10.0	2708	84.6	11.9
Piperacillin	1063	97.7	0.9	1308	98.4	0.7	1317	98.8	0.5	3688	98.3	0.7
Tobramycin	833	71.2	22.1	1385	51.3	41.7	1405	56.2	33	3623	59.6	32.3
Aztreonam	1018	93.4	6.4	1513	97.4	2.4	1570	96.4	3.2	4101	95.7	4.0
Cefuroxime	1344	95.8	4.0	1823	97.9	1.8	1733	97.8	2.0	4900	97.2	2.6
Ceftriaxone	1262	95.2	4.7	1840	98.9	0.9	1972	98.7	1.1	5074	97.6	2.2
Compound sulfamethoxazole	1381	68.4	31.4	1875	47.8	52.1	2025	43.8	56.2	5281	53.3	46.6
Cefazolin	1427	91.5	8.5	2213	98.1	1.9	1960	97.8	2.2	5600	95.8	4.2
Amikacin	1507	56.6	42.1	2142	42.7	56.4	2452	43.9	55.5	6101	47.7	51.3
Ciprofloxacin	1439	81.2	13.6	2152	80.3	16.1	2183	84.2	13.7	5774	81.9	14.5
Piperacillin/tazobactam	1504	90.5	6.7	2169	92.9	4.6	2387	94.0	3.9	6060	92.5	5.1
Meropenem	1501	90.7	6.9	2260	94.5	4.4	2219	94.4	4.1	5980	93.2	5.1
Levofloxacin	1491	79.3	17.9	2290	76.8	20.1	2447	81.9	15.4	6228	79.3	17.8
Ceftazidime	1455	92.4	6.7	1981	95.8	3.0	2422	94.1	4.5	5858	94.1	4.7
Gentamicin	1452	71.4	27.1	2303	57.0	40.6	2169	64.5	33.2	5924	64.3	33.6
Imipenem	1510	90.4	7.0	2322	92.0	5.0	2456	94.5	2.9	6288	92.3	5.0
Cefepime	1507	91.8	5.6	2335	92.5	4.9	2462	91.1	4.9	6304	91.8	5.1
Polymyxin	132	0	100	69	1.5	98.5	99	0	100	99	0.5	99.5

Abbreviations: N, number of strains; R, drug resistance rate; S, sensitivity rate.

Table 4 CRKP MIC50 and MIC90 of CRKP

Projects	Quantity	Break Point	MIC50	MIC90	MIC Range
Tigecycline	962	S≤0.03 R≥0.25	0.5	2	0.02–64
Compound sulfamethoxazole	4978	S≤2 R≥4	4	16	0.25–128
Ciprofloxacin	5430	S≤1 R≥4a	4	8	0.01–64
Etapenan	724	S≤0.5 R≥2	8	16	0.25–64
Levofloxacin	5646	S≤2 R≥8	8	16	0.06–64
Tobramycin	3546	S≤4 R≥16	16	16	0.5–32
Meropenem	5359	S≤1 R≥4	16	32	0.06–128
Gentamicin	5370	S≤4 R≥16	16	16	0.5–32
Amikacin	5479	S≤16 R≥64	16	64	1–128
Imipenem	5658	S≤1 R≥4	16	32	0.12–64
Amoxicillin/clavulanic acid	1027	S≤8 R≥32	32	32	0.5–64
Cefoxitin	2218	S≤8 R≥32	32	64	1–128
Cefepime	5694	S≤2 R≥16	32	64	0.12–128
Cefotaxime	1327	S≤1 R≥4	64	64	0.12–128
Aztreonam	3738	S≤4 R≥16	64	128	0.25–128
Cefuroxime	4528	S≤8 R≥32	64	128	1–128
Ceftriaxone	4624	S≤1 R≥4	64	128	0.12–128
Cefazolin	5074	S≤16 R≥32	64	128	1–128
Ceftazidime	5364	S≤4 R≥16	64	64	0.06–128
Piperacillin	3414	S≤16 R≥128	128	256	2–256
Piperacillin/tazobactam	5643	S≤16 R≥128	128	256	0.5–256

Note: MIC50/MIC90, MIC50 and MIC90 can inhibit 50% or 90% of the tested bacteria.

Abbreviation: MIC, minimum inhibitory concentration.