Impact of antibiotic prescription on the resistance of Klebsiella pneumoniae at a tertiary hospital in China, 2012-2019


      • The incidence of Klebsiella pneumoniae (KP) infections is worrisome.
      • The use of some third-generation cephalosporins and carbapenems continue to increase.
      • Positive relationships existed between amikacin, ciprofloxacin use and resistant KP.
      • Similar results were obtained with different measuring outcomes of resistance.


      The incidence of Klebsiella pneumoniae (KP) infections is worrisome. Previous studies have shown that increased antibiotic treatment might affect the resistance profile of this organism. The objective of this study was to describe the resistance profile of KP strains and to correlate it with antibiotics consumption.


      A retrospective observational analysis was performed to examine exposure to antibiotics and resistant profile, comparing the results of different measuring outcomes of resistance (the incidence and the percentage of resistant KP) during January 2012 to June 2019 by using the autoregressive integrated moving average and transfer function model.


      During the study period, the use of some third-generation cephalosporins and carbapenems continued to increase and a total of 5,519 KP isolates were collected. There were positive relationships between amikacin-resistant KP, ciprofloxacin-resistant KP, and corresponding antibiotic use in the transfer function models; both for the incidence rate and the resistant rate (time lag = 0) (P < .05).


      The present study confirms that the history of amikacin or ciprofloxacin use influences the susceptibility of these agents against KP with no delay. Similar results were obtained with different measuring outcomes of resistance.

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