Detection of Klebsiella Pneumoniae and Antibiotic Resistance in Burn Wards in China From 2019 to 2023.

Abstract

Introduction: The rise of antimicrobial resistance in Klebsiella pneumoniae, especially carbapenem-resistant strains (CRKP), presents a major challenge in burn care. This study aimed to examine the detection trends and resistance patterns of K. pneumoniae in burn wards over five years (2019-2023) and analyze the clinical characteristics of patients with CRKP infections during the last three years.

Methods: A retrospective study was conducted on K. pneumoniae isolates from burn wards, collecting data on bacterial detection and antimicrobial resistance over five years (2019-2023). Clinical records of CRKP-infected patients from the last three years were analyzed, focusing on age, total burn area, third-degree burn area, and prognosis. Statistical analyses assessed resistance trends and correlations between infection outcomes and clinical variables.

Results: The detection rate of Klebsiella pneumoniae and its resistance to common antibiotics have increased annually, particularly for carbapenem-resistant strains (CRKP). Polymyxin resistance among CRKP isolates has also risen. Wound secretions were the primary infection source, accounting for 75.9% of K. pneumoniae isolates, followed by the respiratory tract at 15.2% and blood/venous catheter samples at 8.9%. There was a significant rise in bloodstream CRKP detection rates during the study period. Clinically, CRKP infections were associated with a larger total burn area (mean: 45.3% vs 28.7% in non-CRKP cases) and more extensive third-degree burns (mean: 22.1% vs 12.4%). Mortality rates were higher in patients with CRKP infections compared to those with carbapenem-susceptible infections (34.6% vs 18.2%).

Conclusion: The drug-resistant phenomenon of Klebsiella pneumoniae in the burn ward of our hospital was serious, especially the number of carbapenem-resistant antimicrobial drugs of Klebsiella pneumoniae increased significantly, which should be strengthened to monitor and guide the rational use of drugs in the clinic.