ĐẶC ĐIỂM CỦA KLEBSIELLA PNEUMONIAE KHÓ TRỊ TRÊN NGƯỜI BỆNH COVID-19 TẠI BỆNH VIỆN BỆNH NHIỆT ĐỚI THÀNH PHỐ HỒ CHÍ MINH

Abstract

Objective: Description of K. pneumoniae DTR infection in COVID-19 patients, microbiological characteristics, carbapenemase genotype and treatment outcomes. Subjects and methods: COVID-19 patients with K. pneumoniae infection, from August 2021 to April 2022, at the Hospital for Tropical Diseases of Ho Chi Minh City.Retrospective descriptive analysis. Results: Among the 155 COVID-19 patients including in the study, 280 Klebsiella pneumoniae isolates were identified. Of which, 28.2% were isolated from blood culture samples and sterile fluids, 55.0% from lower respiratory specimens, and 16.8% from other specimens (urine, wound pus). K. pneumoniae was found in 18.1% of patients in two different specimens, and in 1.9% in all three specimens. The rate of cases infected with K. pneumoniae DTR strain was 84.6%, of which K. pneumoniae isolated from lower respiratory specimens had the highest DTR rate of 86.1%. The rate of K. pneumoniae DTR resistant to ertapenem was 84.6%, and resistance to imipenem and meropenem was 83.9%. Among K. pneumoniae DTR. strains, 56.0% of strains carried the OXA-48 gene, 18.0% of strains carried the OXA-48 and NDM genes. For the lower respiratory tract group, 55.5% carried the OXA-48 gene, 16.6% carried both the OXA-48 and NDM genes, and 16.6% had none of the 5 genes examined. Other specimens (urine, wound pus) had 44.4% of cases carrying the OXA-48 gene, 33.3% of cases had NDM, and 0.27% of cases had both genes (OXA-48+NDM/IMP). For blood specimens, 70.0% carried the single OXA-48 gene, 30.0% had both OXA-48 and NDM. 65.8% of patients infected with K. pneumoniae DTR died. No association between genotype and mortality was noted.