Nosocomial Infections and Drug Resistance of Klebsiella pneumoniae

OBJECTIVE To investigate the distribution and the drug resistance of Klebsiella pneumoniae in our hospital,and provide reference for the rational use of antimicrobial agents in clinic.METHODS The strains of K.pneumoniae isolated from clinical samples were identified by the VITEK-32 system.Extended spectrum β-lactamases(ESBLs) were determined by phenotypic confirmatory test.Susceptibility test to antimicrobial agents was performed by disk diffusion methods and analyzed by WHONET 5.3.RESULTS 93.6% Of total 256 strains of K.pneumoniae were isolated from urine,sputum,blood and secretion samples,and 54.3% of them were isolated from sputum.81.6% Of infections caused by K.pneumoniae were frequently occurred in patients in intensive care units(ICU),departments of respiratory medicine and gastroenterology,departments of hematology and endocrinology,cadred wards and department of nephrology.The isolated ratio of ESBLs producing K.pneumoniae were 39.8%.The rates of resistance to piperacillin,cefuroxime,ceftazidime, cefotaxime,ceftriaxone,aztreonam,gentamicin,ciprofloxacin,and sulfamethoxazole/trimethoprim were between 32.4% and 50% in all strains;and the resistance rate to cefoperazone/sulbactam,piperacillin/tazobactam,cefepime,cefoxitin,and amikacin was less than 22.7%.There were isolates producing ESBLs,which showed much higher resistance to antimicrobial agents tested(but susceptible to imipenem and meropenem) than that of non-ESBLs-producing K. pneumoniae(P0.05).49% Of ESBLs producing strains were multidrug resistant.CONCLUSIONS Antimicrobial resistance and the isolation rates of ESBLs producing K.pneumoniae in our hospital are high,and the situation of multidrug resistance of ESBLs producing strains is very prominent.It should be paid attention to the epidemic status of strains and rational use of antimicrobials agents in clinic.