OBJECTIVE To investigate the clinical distribution and dynamic change of drug resistance of K. pneumoniae and carbapenem-resistant Klebsiella pneumoniae (CRKP) isolated from a three-A hospital of Suzhou so as to provide scientific bases for prevention and control of hospital-associated infections and reasonable application of antibiotics.

METHODS The K. pneumoniae and CRKP strains that were isolated from the submitted specimens were collected from the patients who treated in the Affiliated Suzhou Hospital of Nanjing Medical University from 2019 to 2023. The clinical characteristics of the patients with infection and the trend of drug resistance were statistically analyzed.

RESULTS Totally 5631 strains of K. pneumoniae were isolated, 1205 (21.40%) of which were CRKP, and the isolation rate of CRKP showed an upward trend in the five years (χ²=236.352, P < 0.001). Among the K. pneumoniae isolates, 51.59% were isolated from sputum, 13.51% from urine; 19.43% were isolated from intensive care unit (ICU), 7.64% from emergency department, and 7.19% from respiratory department. There were significant differences in gender, age and season between the patients detected with CRKP and the patients detected with non-CRKP (P < 0.05). The drug resistance rates of the K. pneumoniae strains to cephalosporins, quinolones and carbapenems continuously increased from 2019 to 2023(P < 0.001), the drug resistance rate to imipenem increased from 11.69% to 34.24%, meropenem from 10.92% to 34.24%.

CONCLUSIONS The K. pneumoniae isolates show severe drug resistance from 2019 to 2023, and the isolation rate of CRKP strains rises increasingly. It is necessary for the hospital to focus on the continuous monitoring of key populations and departments and optimize the management of antibiotics and infection control strategies so as to provide guidance for reasonable clinical use of antibiotics, effective control of transmission of drug-resistant strains and cope with the increasingly severe drug resistance.