Characterization of carbapenem-resistant Klebsiella pneumoniae in a tertiary hospital in Fuzhou, China

Abstract

Aims: The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) strains has led to increased mortality and morbidity rates. Tigecycline, a new class of broad-spectrum glycyl-tetracycline antibiotics, has been used to target multi- and pan-drug-resistant bacterial infections. This study aimed to assess the molecular characteristics of CRKP in a tertiary hospital, and its susceptibility to tigecycline, to create a reference for hospital infection control and clinical drug use. Methods and Results: We retrieved patient clinical information and CRKP characterization from medical records and detected the MIC of tigecycline using the micro-broth dilution method. Multi-locus sequence typing was performed, and antibiotic resistance genes associated with CRKP were detected by qPCR. A total of 166 CRKP strains were detected in the sputum, urine and blood among intensive care unit patients (average age, 69·6 years). The most infrequently observed resistance genes were amikacin resistance genes, followed by tobramycin resistance genes. KPC-2, CTX-M9 and CTX-M1 were the most frequently detected resistance genes. Conclusions: No strain was resistant to tigecycline (MIC ≥ 8 µg ml−1). Twenty-four sequence types were identified, with ST11 being the most common type. Significance and Impact of the Study: Clinicians and infection control experts should be aware of CRKP prevalence to facilitate clinical treatment and improve nosocomial infection control.