Epidemiological Characteristics and Drug Resistance Analysis of 187 Strains of Carbapenem-Resistant Enterobacteriaceae in a General Hospital

Author:

Zhang MaojieORCID,Zhu Yanqiu,Yang Mei,Huang Yamei,Yu Yang,Wu Shengwei

Abstract

Background: Carbapenem antibiotics are currently the most broad-spectrum and potent β-lactam antibiotics. Without effective intervention measures, Carbapenem-Resistant Enterobacteriaceae (CRE) may become widespread in all healthcare institutions within ten years, potentially developing into an endemic issue. Objectives: To understand the epidemiological characteristics and multilocus sequence typing (MLST) of CRE infections in hospitals, and to explore critical strategies for preventing and controlling CRE hospital infections. Methods: The study focused on hospitalized patients with CRE strains isolated by the Laboratory Department of the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from 2020 to 2022. Patient data, bacterial isolation, culture, and drug sensitivity results were collected and analyzed to determine the epidemiological characteristics of CRE infections. Preserved Carbapenem-Resistant Klebsiella pneumoniae (CRKP) strains were reviewed, and the CRKP sequence type (ST) was obtained through MLST typing. Results: Over the past three years, 187 CRE strains were isolated in the hospital, with infections predominantly occurring in males and individuals over 60 years old. The departments with the highest detection rates were the ICU (35.29%), geriatric department (11.23%), and rehabilitation department (8.02%). The top three specimen sources were sputum (43.85%), clean midstream urine (32.09%), and secretions (13.90%). carbapenem-resistant Klebsiella pneumoniae accounted for the majority of CRE isolates (80.21%), followed by carbapenem-resistant Escherichia coli (14.44%). Carbapenem-resistant Enterobacteriaceae strains exhibited a high resistance rate to most commonly used antibiotics but were sensitive to tigecycline. Multilocus sequence typing results from 11 CRKP strains showed that 90.91% were of the ST11 type, while 9.09% were of the ST15 type. Conclusions: From 2020 to 2022, CRE infections at the hospital primarily affected elderly male patients over 60, with CRKP as the predominant pathogen and ST11 as the main sequence type. Carbapenem-resistant Enterobacteriaceae strains were highly resistant to most commonly used antimicrobial drugs. Hospitals should prioritize the prevention and control of CRE infections, emphasizing the management of antimicrobial drugs, patient identification, environmental hygiene, and infection control measures to prevent outbreaks caused by CRE.

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Briefland

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