NGHIÊN CỨU TÌNH HÌNH ĐỀ KHÁNG KHÁNG SINH CARBAPENEM VÀ SỰ ĐỘT BIẾN GEN KPC, OXA-48 Ở CHỦNG KLEBSIELLA PNEUMONIAE PHÂN LẬP TẠI BỆNH VIỆN ĐA KHOA HOÀN MỸ CỬU LONG NĂM 2024-2025

Abstract

Background: The prevalence of carbapenem-resistant K. pneumoniae (CRKP) is increasing, with KPC and OXA-48 gene mutations playing a crucial role in reducing the effectiveness of this antibiotic class. Objectives: To determine the proportion of CRKP isolates from patients, the prevalence of KPC and OXA-48 gene mutations, and associated risk factors at Hoan My Cuu Long General Hospital. Materials and methods: Descriptive method through cross-sectional survey 224 K. pneumoniae strains isolated from infected patients from June 2024 to February 2025. Results: Among the 224 K. pneumoniae isolates, 88 (39.3%) were identified as CRKP. CRKP infection was associated with patients aged over 60 years, admission to the Intensive Care Unit and General Department, a hospital stay of ≥48 hours and a history of antibiotic use within the preceding month. The prevalence of CRKP strains carrying KPC and OXA-48 gene mutations was 22.7% (20/88) and 73.9% (65/88). The presence of the OXA-48 mutation was significantly associated with a history of antibiotic exposure and resistance to all three carbapenem agents (imipenem, meropenem, and ertapenem), with a notably strong association observed for ertapenem. Conclusions: The prevalence of CRKP is high, with the presence of strains carrying KPC and OXA-48 gene mutations. Factors associated with CRKP infection include patients over 60 years old, treatment in the ICU or General Ward, hospitalization for ≥48 hours, and prior antibiotic use within one month.