Meng Li
Liyan YE
Yu Zhenghao
Hong Wu Yao
liu yunxi
*The final, formatted version of the article will be published soon.
ORIGINAL RESEARCH article
Front. Microbiol.
Sec. Antimicrobials, Resistance and Chemotherapy
Volume 15 - 2024 |
doi: 10.3389/fmicb.2024.1507908
This article is part of the Research Topic Global Dissemination and Evolution of Epidemic Multidrug-Resistant Gram-Negative Bacterial Pathogens: Surveillance, Diagnosis and Treatment, Volume III View all 9 articles
Epidemiology and outcome of carbapenem-resistant Klebsiella pneumoniae infection in patients with hematological malignancies from 2014-2022
Provisionally accepted- First Affiliated Hospital of Chinese PLA General Hospital, Beijing, China
Background We aimed to describe the epidemiology, cross-transmission, intervention and outcome of carbapenem-resistant Klebsiella pneumoniae (CRKP) infection in hematological malignancies (HM) department in one Chinese hospital. Methods This prospective study was divided into three stages from 2014 to 2022 [Period 1 (during Jan 1st 2014 to Mar 4th 2021); Period 2 (during Mar 5th 2021 to Dec 31th 2021) ; Period 3 (during Jan 1st 2022 to Dec 31th 2022)], with different measures at each stage to evaluate the rate of new infections. Risk factors, epidemiological characteristic data of all CRKP patients, NGS gene sequencing molecular epidemiology analysis and cross-transmission were described. Results A total of 217 patients with K. pneumoniae isolates, including 38 (17.5%) patients with CRKP isolates were confirmed in the HM department. The total rate of CRKP in KP isolates was 17.5%. The predominant clone in the HM department was ST11 CRKP producing KPC-2 enzyme (21, 70.0%). 23 cases were HM department acquired CRKP, a total of 5 hospital cross-transmission events were observed, and 4 dissemination of CRKP has been primarily related to clone ST11. Only one outbreak occurred in the end of Period 1 with 4 cases of CRKP healthcare-associated infections. After Period 2 the outbreak intervention bundles, no cross transmission was caused. The rate of CRKP in KP fell to 12.9% (only 4 CRKP isolates) in Period 3 from the peak in Period 2 at 46.7% (including 14 CRKP isolates). Only one new carrier (0.9%) was identified in two cross sections active screening of rectal swab. The 28-day mortality rate was 38.7% (12/31) in CRKP infected patients. Conclusion The prevalence of CRKP in HM department is relatively low in the studied hospital. We found some interventions including single room isolation, enhanced disinfection and skin decolonization played a pivotal role in controlling the spread of HM-acquired CRKP infections.
Keywords: Epidemiology, Klebsiella pneumoniae, Carbapenem-resistant, hematological malignancies, Infections
Received: 08 Oct 2024; Accepted: 09 Dec 2024.
Copyright: © 2024 Li, YE, Zhenghao, Yao, yunxi, guanglei and mingmei. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
liu yunxi, First Affiliated Hospital of Chinese PLA General Hospital, Beijing, China
wang guanglei, First Affiliated Hospital of Chinese PLA General Hospital, Beijing, China
du mingmei, First Affiliated Hospital of Chinese PLA General Hospital, Beijing, China
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