Distribution And Risk Factors Of Carbapenemase In Carbapenem-Resistant Klebsiella Pneumoniae

Objectives:To provide an appropriate reference for the clinical prevention and control of CRKP infection by investigating the molecular epidemiology of CRKP and determine the risk factors of CRKP infection patients.Methods:In total,44 non-duplicated clinical CRKP isolates were collected from September 2018-March 2019 in the microbiology laboratory of the Second Affiliated Hospital of Kunming Medical University.The screening procedures of isolates were performed by the combined disk test(CDT),polymerase chain reaction(PCR),and gene sequencing.Patients with CRKP are comprised in the case group and were compared with the control group of patients infected with carbapenem-susceptible Klebsiella Pneumonia(CSKP)(51).Detailed information of antibiotic resistance in the two groups was also recorded.Moreover,the clinical data was retrieved from electronic case records and a retrospective case-control study was carried out between the two groups.Furthermore.the univariate and multivariate logistic regression analysis were used to examine the contribution of risk factors.Results:Of the 44 CRKP isolates,blaKPC gene was the most prevalent and held a rate of 75%followed by blaNDM-1,blaOXA-48,and blaIMP with a rate of 27.27%,9.09%,and 2.27%,respectively.The resistance rate of antibiotic in the case group was higher than the control group.The univariate regression analysis revealed that the length of hospital stay?14 days before being infected,hospitalization history.duration of antibacterial use before infection?14 days,Carbapenem use before infection,and change of department were the common risk factors for CRKP infection.In addition,the multivariate regression analysis showed that hospitalization history and change of department during hospitalization were independent risk factors for CRKP hospital-acquired infection.Conclusions:To efficiently prevent and control CRKP infection,the following measures should be implemented:reduction of frequency of patients transfer,use of antibiotic should be strictly standardized,disinfection measures for medical devices and surfaces cleaning should be strictly followed,isolation measures should be implemented for patients who are known or suspected to be infected.We strongly believe that the implementation of the above-mentioned measures could effectively alleviate the incidence as well as combat the spread of CRKP infection.