Trend of carbapenemase changes and epidemiological distribution of carbapenem-resistant Klebsiella pneumoniae clinically isolated in a hospital: a single-center retrospective study from 2015 to 2024
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background The spread of carbapenem-resistant Klebsiella pneumoniae (CRKP) has become a concerning threat. In particular, infections caused by CRKP are on the rise globally, posing a major public health challenge to human health. In China, KPC and NDM are the main types of carbapenemases among CRKP strains. Methods We collected 324 strains of CRKP clinically isolated from a Grade A tertiary hospital between 2015 and 2024. Antibiotic susceptibility was tested using the Antibiotic susceptibility was tested using the Kirby-Bauer disk diffusion method and agar dilution method. The carbapenemase phenotypes were confirmed by the modified carbapenem inactivation method (mCIM) and the EDTA-modified carbapenem inactivation method (eCIM). And we detected carbapenemase-encoding genes were detected by polymerase chain reaction (PCR). Analyzed the changing trends of carbapenemases in CRKP strains. Besides, we divide CRKP patients into four groups. Then we analyze the distribution differences in the length of hospital stay, total drug cost, antibacterial drug cost, and outcomes among patients in each group. Results Within the decade from 2015 to 2024, there were significant changes in the carbapenemase types of CRKP. Since 2021, the predominant carbapenemase type in the strains has shifted from NDM to KPC. Among all the included CRKP strains, isolates recovered from pulmonary infection sites and sputum specimens accounted for the largest proportion, totaling 206 strains. The intensive care unit (ICU) yielded the highest number of CRKP strains, with a total of 78 isolates. Intra-group analysis showed that there were statistically significant differences in the length of hospital stay of CRKP patients in the two dimensions of specimen classification and disease classification ( χ 2 disease = 20.899, p < 0.001; χ 2 specimen = 23.586, p < 0.001). There were statistically significant differences in the total drug cost in the three dimensions of disease classification, department classification, and severity classification ( χ 2 disease = 21.224, p < 0.001; χ 2 department = 45.711, p < 0.001; χ 2 severity = 9.571, p = 0.023). There were statistically significant differences in the antibacterial drug cost in the three dimensions of disease classification, severity classification, and specimen classification ( χ 2 disease = 22.916, p < 0.001; χ 2 department = 20.711, p < 0.001; χ 2 specimen = 14.811, p = 0.022). There was a statistically significant difference in the treatment outcomes in the one dimension of severity classification ( χ 2 severity = 14.729, p < 0.001). Conclusion In hospital, the type of carbapenemase produced by CRKP strains has gradually shifted from being predominantly NDM to predominantly KPC over the past decade. The disease types, inpatient departments, severe illness conditions, and sampling specimens of CRKP patients have all had impacts on the patients treatment outcomes.
Source: Frontiers in Public Health
Language: English
Subfield: Microbiology (medical)
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7223129235