Clinical characteristics of different drug-resistance genes of carbapenem resistant Klebsiella pneumoniae in department of respiratory medicine

Objective To analyse the clinical characteristics of different drug-resistance genes (OXA-48 and KPC) of carbapenem resistant Klebsiella pneumoniae (CRKP) in the Department of Respiratory Medicine, Chinese PLA General Hospital, to find intrinsic differences and provide evidence for clinical prevention and treatment. Methods A total of 44 patients infected by CRKP strain in the Department of Respiratory Medicine, Chinese PLA General Hospital from July 2013 to July 2015 were collected.Repetitive strains from the same patient were eliminated.According to the different kinds of enzymes produced by carbapenem, those patients were divided into KPC group and OXA-48 group.The clinical characteristics, the drug susceptibility results and other indicators of two groups were compared. Results 14 cases (31.8%) carried KPC enzyme, 21 cases (61.4%) carried OXA-48 enzyme, two cases (4.5%) carried IMP enzyme.The results of univariate analysis showed that there were no statistical differences between two groups in days of hospitalization before infection, proportions of intensive care unit stay, basic conditions, exposure to invasive interventions (central venous catheter, chest drainage tube, gastric tube, dialysis or continuous renal replacement therapy, tracheal intubation or tracheotomy), mechanical ventilation and endoscopic surgery, medications before confirmation of CRKP and 90-day all-cause mortality.The resistance rate of meropenem in OXA-48 group and KPC group was respectively 55.6% and 92.9%, there was statistical difference between the two groups (P=0.038). The resistance rate of imipenem in OXA-48 group and KPC group was respectively 66.7% and 100.0%, there was statistical difference between the two groups (P=0.041). Conclusions Due to resistance of multiple antibiotics, severe conditions and complicated complications, patients with CRKP infection have high mortality.There is no significant difference in clinical features between different genotypes of CRKP.The different genotypes of CRKP exhibit heterogeneous carbapenem resistance patterns.With the reference of drug-resistant gene status, clinical practice will be more precise. Key words: Klebsiella pneumoniae; Carbapenem; Clinical features