A Polyclonal Spread Emerged: Characteristics of Carbapenem-Resistant Klebsiella pneumoniae Isolates from the Intensive Care Unit in a Chinese Tertiary Hospital
, , e | 08 set 2020
INFORMAZIONI SU QUESTO ARTICOLO
Article Category: original-paper
Pubblicato online: 08 set 2020
Pagine: 311 - 319
Ricevuto: 31 mar 2020
Accettato: 22 lug 2020
DOI: https://doi.org/10.33073/pjm-2020-034
Parole chiave
© 2020 Zhengzheng Wang et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Fig. 1.
Fig. 2.
The corresponding bacterial characteristics and medical records of patients with CRKP acquisition.
| Bacterial strain | Age | Isolation site | ST | Carbapenemases | Underlying conditions | Invasive procedures | Antimicrobial treatment | The length of stay | Outcomes |
|---|---|---|---|---|---|---|---|---|---|
| 1025 | 61 | Wound | NA | NDM-5 | Septic shock, MODS, necrotizing fasciitis | Nasogastric tube, central venous catheter, surgical procedure | IMP, AMC, FEP, MXF, ISE | 23 days | Survived |
| 1029 | 81 | Wound | ST722 | NA | Pulmonary infection, hypertension, diabetes mellitus, | PICC catheter, mechanical ventilation heart disease, encephalorrhagia | IMP, TZP, SCF | 46 days | Stable, discharged |
| 1050 | 73 | Blood | ST11 | NDM-5 | Septic shock, biliary tract infection, COPD, MODS, pulmonary failure | Mechanical ventilation, urinary catheter, deep vein catheter | TZP, IMP, MEM, SCF, TGC | 55 days | Discontinuing treatment |
| 1051 | 89 | Sputum | ST11 | NDM-5 | Pulmonary infection, septic shock, pulmonary failure, hypertension, chronic renal failure, MDS, diabetes mellitus, hypertensive heart disease | Mechanical ventilation, urinary catheter, gastric tube | SCF, TGC | 20 dTays | Death |
| 1052 | 73 | Sputum | ST11 | NDM-5 | Septic shock, biliary tract infection, COPD, MODS, pulmonary failure | Mechanical ventilation, urinary catheter, deep vein catheter | TZP, IMP, MEM, SCF, TGC | 34 days | Discontinuing treatment |
| 1055 | 46 | Drainage fluid | ST1446 | NA | Pulmonary infection, pyothorax, septic shock, pulmonary failure, renal insufficiency, liver cirrhosis | Mechanical ventilation, urinary catheter, deep vein catheter, gastric tube | IMP, TZP, SCF | 38 days | Discontinuing treatment |
| 1062 | 79 | Bronchial perfusate | ST290 | NDM-5 | Pulmonary infection, chronic bronchitis, pulmonary failure, hypertension, cerebral infarction, pleural effusion | Mechanical ventilation, urinary catheter, deep vein catheter, gastric tube | SCF, AMC, FEP | 26 days | Survived |
| 1063 | 79 | Sputum | ST290 | NDM-5 | Pulmonary infection, chronic bronchitis, pulmonary failure, hypertension, cerebral infarction, pleural effusion | Mechanical ventilation, urinary catheter, deep vein catheter, gastric tube | SCF, AMC, FEP | 26 days | Survived |
| 1064 | 61 | Urine | ST290 | NDM-5 | Spinal cord injury, high falling injury, electric injury, pulmonary infection, pulmonary failure, fracture | Mechanical ventilation, urinary catheter, deep vein catheter, gastric tube | TZP, MEM, SCF | 83 days | Stable, discharged |
| 1076 | 42 | Sputum | ST290 | NDM-5 | Craniocerebral trauma, pulmonary contusion, hemorrhagic shock, deep venous thrombosis, renal failure | Mechanical ventilation, urinary catheter, deep vein catheter | TZP, AMC, FEP, ISE, MEM, SCF | 136 days | Death |
| 1102 | 79 | Sputum | ST290 | NDM-5 | Pulmonary infection, pulmonary failure, chronic bronchitis, parkinson | Mechanical ventilation, urinary catheter, deep vein catheter, gastric tube, surgical procedure | SCF, IMP, TZP | 123 days | Survived |
| 1165 | 76 | Drainage fluid | ST11 | KPC | Gastric perforation, peritonitis, fistulo of colon, pulmonary infection, liver cirrhosis | Mechanical ventilation, urinary catheter, deep vein catheter | TZP, IMP, AMC, FEP, TGC, SCF | 18 days | Discontinuing treatment |
| 1233 | 38 | Drainage fluid | ST290 | NA | Retroperitoneal abscess, acute necrotizing pancreatitis, hepatic insufficiency, hyperlipemia | Mechanical ventilation, urinary catheter, deep vein catheter, central venous catheter, drainage tube | TZP, LEV, IMP | 46 days | Discontinuing treatment |
| 1247 | 72 | Urinary catheter | ST11 | KPC | NMS, pulmonary infection, pulmonary failure, diabetes mellitus, hypertension, renal or hepatic insufficiency, hyperlipemia | Mechanical ventilation, urinary catheter, deep vein catheter | TZP | 27 days | Stable, discharged |
| 1762 | 57 | Sputum | ST11 | KPC | Septic shock, pulmonary encephalopathy, COPD, pulmonary failure, hypertension, fungal infection | Mechanical ventilation, urinary catheter, deep vein catheter | SCF, IMP, AMK, FEP | 45 days | Death |
| 1773 | 88 | Urinary catheter | ST11 | NA | Pulmonary infection, pulmonary failure, cerebral infarction, hypertension, diabetes mellitus, alzheimer disease | Mechanical ventilation, urinary catheter, gastric tube | TZP, IMP | 35 days | Stable, discharged |
| 1779 | 39 | Urinary catheter | ST111 | NA | MODS, pulmonary failure, traumatic shock, multiple fracture, sepsis, pulmonary infection, fungal infection | Mechanical ventilation, urinary catheter, deep vein catheter | IMP, SCF, ISE, MXF | 183 days | Survived |
| 1785 | 72 | Urinary catheter | ST11 | KPC | SCAP, pulmonary failure, urinary tract infection, diabetes mellitus, septic shock, fungal infection, pleural effusion | Mechanical ventilation, urinary catheter, deep vein catheter | IMP, SCF, TGC, AZM, MXF | 31 days | Discontinuing treatment |
| 1793 | 70 | Urinary catheter | NA | NA | Pulmonary infection, pulmonary failure, septic shock, fungal infection, cerebral infarction, hypertension, diabetes mellitus, gastrointestinal hemorrhage | Mechanical ventilation, urinary catheter, deep vein catheter, gastrointestinal tube | TZP, SCF, CIP, FEP | 40 days | Survived |
| 1932 | 75 | Sputum | ST11 | NA | Lung cancer, pulmonary infection, bronchiectasis, CHD, hypertension, diabetes mellitus | Mechanical ventilation, urinary catheter, deep vein catheter | TZP, SCF, IMP, TGC | 87 days | Survived |
| 1948 | 78 | Sputum | ST896 | KPC | Cerebral aneurysm, subarachnoid hemorrhage, intracranial infection, pulmonary infection, deep venous thrombosis, fungal infection | Mechanical ventilation, urinary catheter | TZP, MEM, LEV, ISE, IMP, PB | 63 days | Stable, discharged |
| 1975 | 85 | Sputum | ST11 | KPC | Pulmonary infection, pulmonary failure, cardiac failure, cerebral infaction, hypertension | Mechanical ventilation, urinary catheter, deep vein catheter, PICC catheter | IMP, TZP, TGC | 66 days | Stable, discharged |
| 1977 | 85 | Sputum | ST11 | KPC | COPD, pneumonia, pulmonary failure, pulmonary encephalopathy, cardiac failure, renal failure, pulmonary arterial hypertension | Mechanical ventilation, urinary catheter, deep vein catheter, PICC catheter | IMP, SCF, TGC, PB, CAZ/AVI | 46 days | Death |
| 1978 | 78 | Sputum | ST11 | KPC | Pulmonary infection, severe pneumonia, pulmonary failure, renal failure, hypertension, hepatic insufficiency, gastrointestinal hemorrhage, deep venous thrombosis | Mechanical ventilation, urinary catheter, deep vein catheter | SCF, MXF, MEM, IMP, TGC, AMK, PB, CAZ/AVI, MH | 51 days | Discontinuing treatment |
| 1982 | 70 | Sputum | ST11 | NDM-1, KPC | Tonsil carcinoma, hypertension, hyperlipemia, interstitial pneumonia, pulmonary failure, fungal infection | Mechanical ventilation, urinary catheter, deep vein catheter | IMP | 47 days | Stable, discharged |
| 1983 | 82 | Urinary catheter | ST11 | KPC | COPD, pulmonary failure, pulmonary encephalopathy, diabetes mellitus, hypertension, fracture, septic shock, gastrointestinal hemorrhage | Mechanical ventilation, urinary catheter, deep vein catheter, PICC catheter | TZP, IMP, SCF | 37 days | Death |
| 1984 | 66 | Drainage fluid | NA | NDM-1 | Peritonitis, septic shock, pulmonary failure, renal failure, hypertension, fungal infection, intestinal perforation | Mechanical ventilation, urinary catheter, deep vein catheter, PICC catheter, drainage tube | IMP, TGC, TZP, SCF | 43 days | Stable, discharged |
| 1987 | 89 | Sputum | ST11 | KPC | Severe pneumonia, pulmonary failure, CHD, hypertension, rectal cancer, myocardial infarction, fungal infection | Mechanical ventilation, urinary catheter, deep vein catheter | TZP, MEM, SCF, PB, TGC, CAZ/AVI | 22 days | Survived |
| 1990 | 85 | Blood | ST11 | KPC | COPD, pneumonia, pulmonary failure, pulmonary encephalopathy, cardiac failure, renal failure, pulmonary arterial hypertension | Mechanical ventilation, urinary catheter, deep vein catheter, PICC catheter | IMP, SCF, TGC, PB, CAZ/AVI | 46 days | Death |
| 1997 | 82 | Blood | ST11 | KPC | COPD, pulmonary failure, pulmonary encephalopathy, diabetes mellitus, hypertension, fracture, septic shock, gastrointestinal hemorrhage | Mechanical ventilation, urinary catheter, deep vein catheter, PICC catheter | TZP, IMP, SCF | 37 days | Death |