High Prevalence of Klebsiella pneumoniae Infections in AnHui Province: Clinical Characteristic and Antimicrobial Resistance

Abstract

Background: Klebsiella pneumoniae (K. pneumoniae) causes community-acquired and hospital-acquired pneumonia. The mortality rates of invasive infections caused by hypervirulent K. pneumoniae (HvKP) are extremely high. However, the microbiological characteristics and clinical manifestations of K. pneumoniae in AnHui province still remain unclear. Purpose: To show the high prevalence of HvKP infections regarding clinical characteristics and antimicrobial resistance in Anhui province. Patients and Methods: A retrospective analysis was conducted to study the clinical data of 115 strains of K. pneumoniae from July 2019 to March 2020 in The First Affiliated Hospital of AnHui Medical University. The virulence genes, capsular types, carbapenemase genes, and molecular subtypes of these hypervirulent isolates were detected. Results: Overall, 59.1% (68/115) cases were HvKP infections, mainly from the department of intensive care unit (ICU, n=14, 20.6%) and the department of respiratory and critical care (n=13, 19.1%). K2 was the most prevalent capsular serotype (n=26), followed by K1 (n=21). The results of MLST identification of 68 strains showed that ST23 (n=15, 22.1%) was the most common type of ST, followed by ST11 and ST65 (n=12, 17.6%), ST86 (n=9, 13.2%), and ST412 (n=6, 8.8%). Among 68 hvKP strains, 12 isolates were carbapenem resistant, and all except two harboured KPC. Conclusion:The high incidence of carbapenemase producing HvKP in the Anhui province, especially the higher mortality of HvKP, should be paid more attention. Meanwhile, epidemiological surveillance and clinical treatment strategies should be continuously determined and implemented.

Carbapenem resistant Enterobacteriaceae in the livestock, humans and environmental samples around the globe: A systematic review and meta-analysis

“…Klebsiella pneumoniae is a well-known nosocomial pathogen responsible for a wide range of infections, and its association with the blaKPC-2 gene indicates the potential for challenging therapeutic outcomes (CDC, 2010). The high prevalence of this gene among Klebsiella pneumoniae (59%) is similar to what (Su et al, 2021) reported in China. This underscores the importance of this species as a key contributor to the CRE problem, especially in healthcare settings where carbapenems are frequently used.…”

Antimicrobial susceptibility pattern and phenotypic detection of metallo-beta lactamases in K. pneumoniae isolates in a tertiary care hospital

“…28 Su et al, also reported 63.2% isolates from male and 36.8% female patients. 29 However Muzaheed et al, reported higher number of isolates from male patients (80.1%) and lesser from female patients (19.8%). 30 In the present study maximum isolates of K. pneumoniae were obtained from ICU patients (66.5%).…”

“…Gupta et al, Pyakurel et al and Su et al have reported isolation rate of K. pneumoniae 70%, 55.1% and 20.6% from ICU samples respectively. 23,29,31 In the present study the pattern of resistance shown by K. pneumoniae towards various antimicrobials was reported as following amoxicillin/clavulanic acid (90.7%), imipenem (78.3%), meropenem (78.7%), ceftiaxone (95.5%), ciprofloxacin (89.6%), amoxicillin/clavulanic acid (90.7%), cotrimoxazole (85.1%), however isolates were highly sensitive to colistin (95.6%) followed by amikacin (76.7%) and tigecycline (63.7%). 31,[39][40][41] Hoang et al had reported 95% MBL production in K. pneumoniae isolates, which is quite higher as compared to this study.…”

Epidemiological characteristics and molecular evolution mechanisms of carbapenem-resistant hypervirulent Klebsiella pneumoniae

“…OmpK36 can reduce the sensitivity of ESBL and AmpC β-lactamase of CRKP and is closely related to the resistance of CRKP to carbapenems (Wang et al, 2009). In a retrospective study with 28 cases of CRKP infections Yao et al, 2015;Zhang et al, 2015;Liu et al, 2016;Zhang et al, 2016;Liu et al, 2017;Zhan et al, 2017;Dong et al, 2018;Feng et al, 2018;Huang et al, 2018;Wei et al, 2018;Gu et al, 2018a,b;Dong et al, 2019;Liu and Su, 2019;Shen et al, 2019;Shu et al, 2019;Xu et al, 2019;Yuan et al, 2019;Zhou et al, 2019;Li et al, 2019b;Hao et al, 2020;Jin et al, 2020;Liu et al, 2020;Yang et al, 2020;Zhang et al, 2020;Zheng et al, 2020;Zhou et al, 2020;Li et al, 2020a,b;Huang et al, 2021;Jin et al, 2021;Liu et al, 2021;Shao et al, 2021;Su et al, 2021;Xie et al, 2021;Yan et al, 2021;Zhang et al, 2021;Zhao et al, 2021;Zhou et al, 2021;Li et al, 2021a,b;Yang et al, 2021b;Wei et al, 2022;Zhou et al, 2022; f...…”

“…As shown in Table 1, Asia is the main epidemic area of CR-hvKP, represented by China, India and Singapore. China reported the largest number of CR-hvKP strains among these countries, and the most common sequence type was ST11 (Zhang et al, 2017), followed by ST23 (Su et al, 2021), ST25 (Li et al, 2019b) and ST65 (Su et al, 2021). The most common capsular serotypes were K1 (Zhang et al, 2016) and K2 (Su et al, 2020), followed by K64 (Hao et al, 2020).…”