Analysis of Antibiotic Resistance and Molecular Characteristics in Carbapenem-Resistant Klebsiella pneumoniae Clinical Isolates

The global epidemic of carbapenem-resistant Klebsiella pneumonia (CRKP) has brought a significant public health challenge. We collected 62 clinical isolated CRKP strains to investigate the antibiotic resistance, molecular characteristics and the clinical characteristics of infected patients. The carbapenemase gene, virulence-associated gene, capsular serotype gene and fenestra protein gene were detected by PCR. All the CRKP isolates were resistant to meropenem, piperacillin-tazobactam, and ceftazidime (100%, 62/62, respectively), followed by imipenem and cefepime (96.8%, 61/62, respectively). The resistance rate of colistin was lowest (11.9%, 8/62). The resistance rate of CRKP in ICU to various antibiotics were significantly higher than general ward patients. 50 strains carried carbapenemase gene bla KPC , and 3 strains carry both bla KPC and bla NDM . The virulence genes uge, wabG , ycf , entB , ureA and fimH were detected above 90% in 62 CRKP strains. 2 strains in 62 CRKP strains had Ompk35 , Ompk36 and Hcp gene deletion. Bla KPC , rmpA and rmpA2 genes have the highest positive rate in blood samples, and bla NDM have the highest positive rate in stool samples. The multivariate analysis showed that patient with pulmonary disease affected the prognosis of the CRKP infection. Our results demonstrated that antibiotic resistance and widespread dissemination of CRKP has become one of the most difficult challenge in clinical infection therapy. The relevant genes of strains and clinical characteristics of patients are related to the progression and prognosis of CRKP infection.