PDF(Pubmed)
Abstract：
UNASSIGNED: Carbapenem-resistant Klebsiella pneumoniae (CRKP) have been extensively disseminated worldwide, resulting in increased mortality. We performed a retrospective analysis of the epidemiology and risk factors for the outcome of CRKP infection in a general teaching hospital in China.
UNASSIGNED: A molecular and clinical study was conducted for 98 CRKP in a tertiary hospital from January 2013 to December 2016. Carbapenemase gene detection, pulsed-field gel electrophoresis (PFGE), and multilocus sequence typing (MLST) were performed. Logistic regression was also used to identify the risk factors associated with 30-day mortality.
UNASSIGNED: The production of KPC carbapenemase was the main resistant mechanism, and KPC carbapenemase increased annually with a significant difference. However, the molecular outcome revealed the dominance and diversity in CRKP with 24 sequence types (STs) and 59 PFGE types (PTs). The ST11 CRKP strains, which showed a significant increasing trend year by year, were documented as predominant in our study. Additionally, the predominant ST11 CRKP corresponding to PT10 and PT15 continued to exhibit their characteristic patterns. Importantly, the newly identified PT09 and PT16 strains, corresponding to the ST11 lineage, were only discovered in 2016. Meanwhile, factors affecting 30-day mortality and ST11 proportionality with CRKP infection were assessed, and ST11, appropriate empirical treatment, and hospital stays were found to be independently associated with 30-day mortality.
UNASSIGNED: The ST11 CRKP strains played a dominant role in the process; however, the homology of these strains was polymorphic, and the advantage clusters were subject to changes through evolution. Furthermore, in addition to appropriate empirical treatment and hospital stays, ST11 CRKP was independently associated with 30-day mortality. To the best of our knowledge, this association was reported for the first time.
UNASSIGNED: A molecular and clinical study was conducted for 98 CRKP in a tertiary hospital from January 2013 to December 2016. Carbapenemase gene detection, pulsed-field gel electrophoresis (PFGE), and multilocus sequence typing (MLST) were performed. Logistic regression was also used to identify the risk factors associated with 30-day mortality.
UNASSIGNED: The production of KPC carbapenemase was the main resistant mechanism, and KPC carbapenemase increased annually with a significant difference. However, the molecular outcome revealed the dominance and diversity in CRKP with 24 sequence types (STs) and 59 PFGE types (PTs). The ST11 CRKP strains, which showed a significant increasing trend year by year, were documented as predominant in our study. Additionally, the predominant ST11 CRKP corresponding to PT10 and PT15 continued to exhibit their characteristic patterns. Importantly, the newly identified PT09 and PT16 strains, corresponding to the ST11 lineage, were only discovered in 2016. Meanwhile, factors affecting 30-day mortality and ST11 proportionality with CRKP infection were assessed, and ST11, appropriate empirical treatment, and hospital stays were found to be independently associated with 30-day mortality.
UNASSIGNED: The ST11 CRKP strains played a dominant role in the process; however, the homology of these strains was polymorphic, and the advantage clusters were subject to changes through evolution. Furthermore, in addition to appropriate empirical treatment and hospital stays, ST11 CRKP was independently associated with 30-day mortality. To the best of our knowledge, this association was reported for the first time.
摘要：
■耐碳青霉烯类肺炎克雷伯菌（CRKP）已在全球范围内广泛传播，导致死亡率增加。我们对中国某综合性教学医院CRKP感染的流行病学和危险因素进行了回顾性分析。
■于2013年1月至2016年12月在某三级医院对98CRKP进行了分子和临床研究。碳青霉烯酶基因检测,脉冲场凝胶电泳(PFGE),进行多位点序列分型(MLST)。Logistic回归也用于确定与30天死亡率相关的危险因素。
■KPC碳青霉烯酶的产生是主要的耐药机制，KPC碳青霉烯酶逐年增加，差异有统计学意义。然而,分子结果揭示了具有24种序列类型（STs）和59种PFGE类型（PTs）的CRKP的优势和多样性。ST11CRKP菌株，呈逐年显著增长趋势，在我们的研究中被记录为主要的。此外,与PT10和PT15相对应的主要ST11CRKP继续表现出它们的特征模式。重要的是,新鉴定的PT09和PT16菌株，对应于ST11谱系，直到2016年才被发现。同时,评估了影响30天死亡率和ST11与CRKP感染比例的因素，和ST11，适当的经验处理，并且发现住院时间与30日死亡率独立相关.
■ST11CRKP菌株在此过程中起着主导作用；但是，这些菌株的同源性是多态的，优势集群会随着进化而发生变化。此外，除了适当的经验性治疗和住院时间，ST11CRKP与30天死亡率独立相关。据我们所知,这一关联是首次报道。
■于2013年1月至2016年12月在某三级医院对98CRKP进行了分子和临床研究。碳青霉烯酶基因检测,脉冲场凝胶电泳(PFGE),进行多位点序列分型(MLST)。Logistic回归也用于确定与30天死亡率相关的危险因素。
■KPC碳青霉烯酶的产生是主要的耐药机制，KPC碳青霉烯酶逐年增加，差异有统计学意义。然而,分子结果揭示了具有24种序列类型（STs）和59种PFGE类型（PTs）的CRKP的优势和多样性。ST11CRKP菌株，呈逐年显著增长趋势，在我们的研究中被记录为主要的。此外,与PT10和PT15相对应的主要ST11CRKP继续表现出它们的特征模式。重要的是,新鉴定的PT09和PT16菌株，对应于ST11谱系，直到2016年才被发现。同时,评估了影响30天死亡率和ST11与CRKP感染比例的因素，和ST11，适当的经验处理，并且发现住院时间与30日死亡率独立相关.
■ST11CRKP菌株在此过程中起着主导作用；但是，这些菌株的同源性是多态的，优势集群会随着进化而发生变化。此外，除了适当的经验性治疗和住院时间，ST11CRKP与30天死亡率独立相关。据我们所知,这一关联是首次报道。
