Drug resistance to Klebsiella pneumoniae and use density of antibacterial agents, and their correlation analysis

ObjectiveTo analyze the drug resistance of Klebsiella pneumoniae(KPN) and use density of antibacterial agents, and their correlation, and provide recommendation for clinical use of antibacterial drugs.

MethodsThe detection rate and drug resistance of KPN, and antibiotics use density(AUD) in the inpatients from 2017 to 2018 were retrospectively analyzed, and the correlation of AUD with drug resistance rate was investigated using Spearman correlation analysis.

ResultsThe detection rate of KPN of producing extended-spectrum β-lactamases(ESBLs) in the first quarter of 2018 was lower than that in the same period of 2017(P < 0.05).The detection rates of carbapenem-resistant KPN(CRKP) of producing ESBLs in the first and fourth quarter, and full year of 2018 were higher than that in the same period of 2017(P < 0.05 to P < 0.01).The drug resistance rate of KPN to cefazolin in 2018 decreased compared with that in 2017(P < 0.01).In 2018, the drug resistance rates of KPN to ampicillin, ampicillin/sulbactam, ceftazidime, ceftriaxone, cefotetan, cefepime, gentamicin, amikacin, ciprofloxacin, SMZ-TMP, tobramycin, imipenem and piperacillin/tazobactam were significantly higher than those in 2017(P < 0.05 to P < 0.01).The drug resistance rate of KPN to erapenem increased from 0% in 2017 to 17.9% in 2018(P < 0.01).The antibiotics with high AUD value included ceftiamidine, cefuroxime sodium, piperacillin tazobartan, cefoxitin and levofloxacin.In 2018, the AUD of the first and second generation cephalosporins, compound preparations containing β-lactamase inhibitors and carbapenes decreased compared with that in 2017, especially the decline of cefuroxime sodium and cefotiam was obvious.The AUD of the second generation cephalosporin was positively correlated with the drug resistance rate of KPN to cefazolin, and negatively correlated with the drug resistance rate of ampicillin, cefotetan and ertapenem(P < 0.05 to P < 0.01).The AUD of ceftriaxone sodium was positively correlated with the drug resistance rate of KPN to ceftetan(P < 0.05), the AUD of ceftriaxone sulbactam sodium was positively correlated with the drug resistance rate of KPN to ampicillin, ceftetan, ertapenem and amikacin(P < 0.05 to P < 0.01), and negatively correlated with cefazolin(P < 0.05).The AUD of carbapenems was negatively correlated with the drug resistance rate of KPN to ampicillin sulbactam and trimoxazole(P < 0.05).

ConclusionsThe drug resistance of KPN is becoming more and more serious, and the detection rate of CRKP is increasing.There is a certain correlation between drug resistance rate of KPN and AUD.It is necessary to use antibiotics reasonably and curb the occurrence of drug resistance.