Disease burden and molecular epidemiology of carbapenem-resistant Klebsiella pneumonia infection in a tertiary hospital in China.

BACKGROUND: Carbapenem-resistant Klebsiella pneumoniae (CRKP) has become an urgent global public health issue, but its distribution has obvious regional differences. The purpose of this study was to investigate the patient-based disease burden and molecular epidemiology of CRKP infections in a tertiary hospital in northern Jiangsu Province in China. METHODS: A retrospective, epidemiological survey of CRKP infections in our hospital from January to December 2016 was conducted to collect clinical and epidemiologic data. Non-duplicated clinical CRKP isolates were collected for the resistance-associated genes and clonal correlation analysis by PCR, sequencing and multilocus sequence typing (MLST). RESULTS: 252 CRKP infection cases were collected, and the annual CRKP infection incidence of the hospital during 2016 was 14.64 per 10,000 hospital discharges (252/172,112*10,000) and 13.78 per 100,000 patient days (252/1,829,190*100,000). The patient-based disease burden concentrated on antimicrobial exposure history (133/224, 59.37%)-the most dominant STs. KPC-2 (120/128, 93.8%) was the predominant carbapenemase and ST11 (98/128, 76.5%) was the dominant STs. One isolate was detected with harboring bla KPC-2 and bla MCR-1 simultaneously. CONCLUSIONS: Patient-based disease burden and KPC-2-producing ST11 Klebsiella pneumonia caused in higher CRKP incidence in the hospital. The emergence of CRKP with bla KPC-2 and bla MCR-1 should be of concern.