Epidemic characteristics,drug resistance characteristics and prognosis of CR-hvKP infection in patients with sepsis
LIU Shuo-yi
GU Quan
LI Hui-ping
LU Cheng-fei
Abstract：Objective:To Explore the epidemiological characteristics,drug resistance characteristics and prognosis of carbapenem resistant highly virulent Klebsiella pneumoniae(CR hvKP)in patients with sepsis.Methods:A total of 106 strains of carbapenem resistant Klebsiella pneumoniae(CRKP)isolated from 99 sepsis patients in our hospital from January 2017 to October 2023 were collected.CR-hvKP as well as its resistance and virulence genes were detected.Meanwhile,clinical data and 28-day mortality of CR-hvKP-infected and non CR-hvKP-infected patients were analyzed.Results:Among 106 strains of CPKP,28 were determined as CR-hvKP.CR-hvKP was completely resistant to ampicillin,cefoperazone sulbactam,piperacillin tazobactam,imipenem,meropene and ceftazidime but relatively sensitive to polymyxin and tigecycline.The detection rates of rmpA,iutA,and rmpA2 genes in CR hvKP strains were 92.86%(26/28),82.14%(23/28)and 85.71%(24/28),respectively,which were significantly higher than those in non CR hvKP strains(16.67%(13/78),26.92(21/78),15.38(12/78))(P<0.05).There was no statistically significant difference in the magA,wcaG,ybtS,entB,and kfu9 genes between CR hvKP and non CR hvKP strains(P>0.05).The proportion of CR hvKP patients with diabetes was 45.83%(11/24),which was higher than that of non CR hvKP patients(17.33%(13/75))(P<0.05).The C-reactive protein(CRP),procalcitonin(PCT),and sequential organ failure estimation(SOFA)scores of CR-hvKP patients were 145.54(101.22,350.40)mg·L-1,4.45(2.01,8.82)ng·mL-1,and 15(7,20),respectively,which were higher than those of non CR-hvKP patients(99.23(67.45,144.45)mg·L-1,2.01(1.34,4.80)mg·L-1,10(5.14))(all P<0.05).The 28-day mortality in CR hvKP patients was 45.83%(11/24),which was higher than that in non CR hvKP patients 12%(9/75)(P<0.05).Conclusion:Among sepsis patients infected with CRKP,a certain proportion of them are infected with CR-hvKP.CR-hvKP is resistant to most antibiotics and relatively sensitive to polymyxin and tigecycline.Patients infected with CR-hvKP have poor prognosis.
Keywords：SepsisHighly virulent Klebsiella pneumoniae resistant to carbapenemDrug resistancePrognosis
Publication Date：2023-08-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 211-215 )