Surveillance On Antimicrobial Resistance In Clinical Isolates Of Klebsiella Pneumoniae From2010to2013

Objective To study the epidemiological and clinical characteristics ofthe infection of Klebsiella pneumoniae, and to investigate the antibioticresistance and the extended spectrum ? lactamase-producing strains ofclinical isolates0f Klebsiella pneumoniae from the first Affiliated Hospitalof Chongqing Medical University during2010-2013to guide therational use of antibiotics.Methods Through retrospective analysis methods, samples(sputum,urine? pus, feces, blood, bile, pleural effusion,wound and woundsecretions)of Klebsiella pneumoniae and the date of clinical cases werecollected from the first Affiliated Hospital of Chongqing MedicalUniversity between January2010and December2013,removed the samestrain of the same patient.WHONET5.6and SPSS17.00software wereused to analyze the data.Results?Epidemiology and clinical features:There were707cases ofKlebsiella pneumoniae from the first Affiliated Hospital of ChongqingMedical University between January2010to December2013, male469,female238, male-female ration=1.96:1,and the oldest patient was90 years old,the younger was15years old,the median age is56±17years.The patients who are equal to or older than60yearsccounted for54.7%, in which60to69years old125cases,70yearsold or older than70years262cases. The majority of theKlebsiella pneumoniae patients were infected during summer andautumn, mainly between June and November.?Distribution of bacteria:During the four years from2010to2013,5931pathogens wereisolated.Enterobacteriaceae of3711, Klebsiella pneumoniae of707,andthe Klebsiella pneumoniae accounted for19.1%inenterobacteriaceae, mainly the proportion were20.8%?16.8%?18.7%,?24.7%respectively. Clinical specimens of Klebsiella pneumoniae mainlycomes from sputum, blood, urine, pus, secretions, with the proportionof58.8%,10.5%,8.3%,5.5%,8.2%repectively.The section distributionis as follows:162cases in intensive care unit(22.9%),321cases inmedical ward (45.4%),211cases in surgical ward (29.8%).?Cases ofKlebsiella pneumoniae producing ESBLs:There were276ESBLs-producing strains which accounted for39.0%in the707Klebsiella pneumoniae strains in our study. From2010to2013,theextended spectrum ? lactamase(ESBLs)-producing Klebsiella pneumoniaewere accounted for38.8%,36.4%,38.1%,48.9%respectively.?Susceptibility results:The insusceptibility of various antibiotics inKlebsiella pneumoniae from2010to2013were as follows: highly resistant to ampicillin(97.3%), and piperacillin(40.9%),cephalosporin(30.9-51.1%.), imipenem (5.9%), meropenem(4.1%),cefoxitin(13.6%), amikacin(7.4%), gentamicin (32.1%),while theinsensitive rates of ampicillin/tazobactam, piperacillin/tazobactam,cefoperazone/sulbactam,in sequenes, were44.8%,10.2%,12.3%,andthe resistance rate to ciprofloxacin were around25%.Conclusion: Because of the increasing infection rates ofKlebsiella pneumoniae and the growing trends of ESBLs-producing Klebsiella pneumoniae strains year by year,we should paymore attention to the resistance to various antibiotics inbacterium.So the resistance surveillance is of great importancefor clinically rational usage of antimicrobials.