Klebsiella pneumoniae is a common nosocomial pathogen
involved in many infectious diseases such as bacteraemia,
urinary and respiratory tract infections. It is
responsible for the rise in morbidity and mortality rates
since most clinical isolates exhibit resistance to several
antibiotics. Moreover, the epidemiology of these nosocomial
infections is variable across countries and regions.
From January 2015 to December 2017 we retrospectively
analysed the bloodstream infections caused by K. pneumoniae
strains in hospitalised patients with the aim of
studying the temporal trends of wild type (WT), multi-
drug resistant (MDR), extended drug resistant (XDR),
pan-drug resistant (PDR) and carbapenem-resistant
(CR) strains. In all, 439 K. pneumoniae isolates from 356
patients were collected from all units of the Policlinico
of Bari. The majority of clinical isolates were collected
from the intensive care unit (125, 28.47%), haematology
(34, 7.74%), rehabilitation (27, 6.15%) and cardiac
surgery wards (25, 5.69%). Moreover, the majority of
SUMMARY
the isolates were classified as CR (325, 74.03%, 95%CI:
69.61-78.19) and XDR (255, 58.09%, 95%CI: 53.31-62.72).
Annual prevalence rates and monthly counts were analysed
using the Chi Squared test for trends and the
Poisson regression with multiple p-value correction
according to Benjamini and Hochberg’s procedure. The
annual relative frequencies of the XDR and CR K. pneumoniae
isolates decreased significantly from 63.37% to
48.44% and from 78.48% to 63.28% respectively, while
WT K. pneumoniae significantly increased from 13.95%
to 23.44%. Poisson regression analysis confirmed the
presence of a decreasing monthly trend for the XDR and
CR K. pneumoniae count series. In order to control the
spread of antibiotic resistance, more inclusive surveillance
data will be needed to either confirm these results
or improve antibiotic stewardship measures