Prevalence, risk factors and molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae in patients from Zhejiang, China, 2008-2018

Emerg Microbes Infect. 2020 Dec;9(1):1771-1779. doi: 10.1080/22221751.2020.1799721.

Abstract

Carbapenem-resistant Klebsiella pneumoniae (CRKP) is emerging as a worldwide public health concern; however, the long-term molecular epidemiological surveillance of clinical CRKP in China is limited. We conducted a retrospective observational study (2008-2018) to assess the prevalence, susceptibility, risk factors and molecular epidemiology of clinical CRKP isolates. We found the prevalence of CRKP increased from 2.5%, 2008 to 15.8%, 2018. CRKP were significantly more frequent among hospitalized patients from ICU, and it was significantly more likely to be isolated from the capital city (Hangzhou) and the patients aged ≥60 years. Additionally, seasons and specimen types were associated with CRKP infections. The main CRKP sequence type (ST) was ST11, and bla KPC-2 was the most prevalent gene variant. Together these data reveal an increasing incidence and resistance trends among CRKP, especially the ST11-bla KPC-2-CRKP, in Zhejiang, during 2008-2018. Our findings are important for hospitals to limit its dissemination and optimize antibiotic administration.

Keywords: Carbapenem-resistant; Klebsiella pneumoniae; molecular epidemiology; risk factor; surveillance.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Proteins / genetics*
  • Carbapenem-Resistant Enterobacteriaceae / isolation & purification*
  • Carbapenems / pharmacology
  • China / epidemiology
  • Humans
  • Klebsiella Infections / drug therapy
  • Klebsiella Infections / epidemiology*
  • Klebsiella pneumoniae / drug effects
  • Klebsiella pneumoniae / genetics
  • Klebsiella pneumoniae / isolation & purification*
  • Microbial Sensitivity Tests
  • Molecular Epidemiology
  • Prevalence
  • beta-Lactamases / genetics*

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Carbapenems
  • beta-Lactamases
  • beta-lactamase KPC-2, Klebsiella pneumoniae
  • carbapenemase-2, Klebsiella pneumoniae

Grants and funding

This work was funded by the National Natural Science Foundation of China (grant numbers 81861138052, 81861138051) and Natural Science Foundation of Zhejiang Province (grant number LY20H200006).