Xu Sun,1 Rui Li,2 Jun Xiang1 

1Department of Burn, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 2School of Medicine, Nankai University, Tianjin, 300071, People’s Republic of China

Correspondence: Jun Xiang, Department of Burn, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China, Email 13801789791@163.com

Introduction: The rise of antimicrobial resistance in Klebsiella pneumoniae, especially carbapenem-resistant strains (CRKP), presents a major challenge in burn care. This study aimed to examine the detection trends and resistance patterns of K. pneumoniae in burn wards over five years (2019– 2023) and analyze the clinical characteristics of patients with CRKP infections during the last three years.
Methods: A retrospective study was conducted on K. pneumoniae isolates from burn wards, collecting data on bacterial detection and antimicrobial resistance over five years (2019– 2023). Clinical records of CRKP-infected patients from the last three years were analyzed, focusing on age, total burn area, third-degree burn area, and prognosis. Statistical analyses assessed resistance trends and correlations between infection outcomes and clinical variables.
Results: The detection rate of Klebsiella pneumoniae and its resistance to common antibiotics have increased annually, particularly for carbapenem-resistant strains (CRKP). Polymyxin resistance among CRKP isolates has also risen. Wound secretions were the primary infection source, accounting for 75.9% of K. pneumoniae isolates, followed by the respiratory tract at 15.2% and blood/venous catheter samples at 8.9%. There was a significant rise in bloodstream CRKP detection rates during the study period. Clinically, CRKP infections were associated with a larger total burn area (mean: 45.3% vs 28.7% in non-CRKP cases) and more extensive third-degree burns (mean: 22.1% vs 12.4%). Mortality rates were higher in patients with CRKP infections compared to those with carbapenem-susceptible infections (34.6% vs 18.2%).
Conclusion: The drug-resistant phenomenon of Klebsiella pneumoniae in the burn ward of our hospital was serious, especially the number of carbapenem-resistant antimicrobial drugs of Klebsiella pneumoniae increased significantly, which should be strengthened to monitor and guide the rational use of drugs in the clinic.

Keywords: burn, klebsiella pneumoniae, drug resistance, antibiotic, antimicrobial