Objective: To analyze the drug resistance data of
carbapenem-resistant Klebsiella pneumoniae (CRKP) collected in 19 tertiary hospitals in the China Antimicrobial Resistance Surveillance Trial Program from 2007 to 2018. Methods: According to the unified plan, clinical isolates of Klebsiella pneumoniae were collected from 19 tertiary hospitals in 19 cities in mainland China. The minimum inhibitory concentrations (MIC) were determined by a twofold
agar dilution method, and antimicrobial susceptibility was established. The isolates were characterized by antimicrobial susceptibility testing, and their drug resistance data were analyzed. Results: In total, 302 strains of CRKP were screened from 3,671 strains of K. pneumoniae. The clinical isolation rate of CRKP increased from 0.9% to 19.9% in the past 12 years, and the isolation rate of CRKP in pediatric patients increased the fastest, to 24.7%. Along this period, the isolation rate in the intensive care unit was higher than that in other settings. The number of CRKP strains with
imipenem and
meropenem MIC ≤8 mg/L decreased from 63.6% to 11.7% and from 72.7% to 14.2%, respectively. Resistance to drugs that may be used to treat drug-resistant
bacterial infections has increased to varying degrees, and CRKP has the lowest resistance rate to
polymyxin B (<19.0%). Conclusion: Because the MIC of CRKP is increasing each year in China,
carbapenems are less likely to be used as part of combined
therapy to treat CRKP
infections. It is difficult to obtain good
therapeutic effects against CRKP
infections with MICs that are too high. CRKP is still the most sensitive to
polymyxin B in vitro, followed by
tigecycline. Combination
therapy may be the most effective current treatment for CRKP
infection.