Objective To investigate the clinical distribution and drug resistance of tigecycline-resistant Klebsiella pneumoniae(TRKP), and to provide evidence for clinical prevention and treatment.
Methods Total 261 strains of TRKP isolated from various samples of inpatients from Shaoxing People's Hospital from January 2015 to December 2018 were collected. VITEK-2 compac automatic microbial analyzer was used for bacterial identification and drug susceptibility test. The sensitivity of other clinical commonly used antimicrobial agents was measured by K-B method. Clinical distribution characteristics of TRKP and its resistance to antimicrobial agents were studied and analyzed.
Results The 261 strains of TRKP were isolated mainly from sputum(
n=123, 47.13%), urine(
n=55, 21.07%) and bile(
n=37, 14.18%), and the stains were mainly originated from ICU(including Emergency ICU), department of hepatobiliary surgery and department of neurosurgery(including Neurosurgery ICU), accounting for 22.61%, 17.62% and 15.71%, respectively. Among the 22 antimicrobial agents, TRKP was more than 80% resistant to 5 and 50% resistant to 14. The resistant rate of TRKP strains which were also resistant to carbapenem was over 90% to 16 species antimicrobial agents and over 80% to 20 species. A total of 249 strains of TRKP, accounting for 95.40%, were multidrug-resistant strains. Furthermore, 93 TRKP strains which were also resistant to carbapenem, accounting for 100%, were multidrug-resistant strains. The overall resistance rate of TRKP to amikacin was relatively low at 16.09%, and the resistance rate to various antibiotics in the department of hepatobiliary surgery was not higher than that in the ICU and the department of neurosurgery.
Conclusion There is a wide range of clinical distribution of TRKP, of which the drug resistance is serious. Antimicrobial agents can be available is limited for treatment of TRKP, and amikacin is one of the few optional drugs.
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