OBJECTIVE To monitor the distribution and drug resistance of carbapenem-resistant Klebsiella pneumoniae (CRKP) strains isolated from the patients with bloodstream infections between 2014 and 2023.

METHODS The clinical data were collected from the patients who were hospitalized in the First Medical Center of Chinese PLA General Hospital from Jan. 1, 2014 to Dec. 31, 2023. K. pneumoniae strains were isolated from clinically submitted blood specimens. The baseline data of the patients, departments and drug resistance were statistically analyzed, and the changes in the 10 years were observed.

RESULTS Totally 544 strains of CRKP were detected from the 1, 020 strains of K.pneumoniae, with the isolation rate 53.33%. The isolation rate of CRKP strains was increased from 34.78% in 2014 to 74.29% in 2020, it was decreased to 53.04%, showing a downward trend after 2020, and there was significant difference among the years(P < 0.05). The 544 strains of K.pneumoniae were isolated from 24 departments, the isolation rate was the highest in hepatobiliary surgery department (including care units) during the 10 years, followed by respiratory medicine department (including care units) and intensive care unit. The result of drug susceptibility testing showed that the drug resistance rates of the K.pneumoniae strains to 15 types of antibiotics except for tigecycline fluctuated with the years; the drug resistance rate to carbapenems imipenem was the lowest (27.40%) in 2014, the highest (78.43%) in 2020; the drug resistance rate to ertapenem was the lowest (34.25%) in 2014, the highest (78.00%) in 2020; the drug resistance rates to the above antibiotics were about 60% after 2020.

CONCLUSIONS The distribution and drug resistance of the CRKP strains isolated from the patients with bloodstream infections show certain changes in the 10 years, the isolation rate and drug resistance rate decline to a certain extent after 2020. It is necessary for the key departments to reasonably use antibiotics based on the results of surveillance of bacterial drug resistance and drug susceptibility testing so as to curb the emergence and development of drug-resistant strains.