关键词: 耐碳青霉烯肺炎克雷伯菌, 危险因素, 耐药, 毒力基因

Abstract: Objective: To investigate the risk factors and resistance gene characteristics of carbapenem resistant Klebsiella
pneumoniae（ CRKP） infections in the Chongming Branch of Shanghai Tenth People′s Hospital. Methods: Clinical data were collected
from 103 patients with CRKP infections and 327 patients with non-CRKP infections between June 2017 and June 2023. Multivariate
Logistic regression analysis was used to identify the risk factors for CRKP infections. PCR was employed to detect the expression of
resistance and virulence genes in CRKP strains, and capsular serotyping was performed. Results: The result of multivariate Logistic
regression analysis showed that using ≥3 antimicrobial agents, mechanical ventilation, using urinary catheters, having ≥3 kinds of
underlying diseases, and having serum albumin levels <30 g/L were independent risk factors for patients to develop CRKP infection （P
<0.05）. There were 73 strains （accounting for 70.87%） carrying the KPC gene, 12 strains （accounting for 11.65%） carrying the NDM
gene, 7 strains （accounting for 6.80%） carrying the VIM gene, and 4 strains （accounting for 3.88%） carrying the OXA-48 gene.
Virulence gene detection revealed the following rates: rmpA （16.50%）, rmpA2 （18.45%）, iroN （17.48%）, iroB （12.62%）, peg-344
（8.74%）, and iutA （18.45%）. Conclusion: CRKP infections in hospitalized patients are influenced by multiple factors, with KPC,
NDM, and VIM being the predominant resistance genes. Some strains also carry high-virulence genes. Clinical efforts should be
enhanced to prevent infections in high-risk populations and to curb bacterial transmission.

Key words: carbapenem resistant Klebsiella pneumoniae, risk factor, antibiotic resistance, virulence gene