The occurence and pathogenicity of B-class Carbapenemase – producing Enterobacteriaceae – Klebsiella Pneumoniae strains (MBL/NDM) in patients hospitalized and treated in Mazowiecki Memorial Hospital of Radom between 2016-2018

Aim
The aim of the study was to characterize symptomatic infections and asymptomatic carrier of class B carbapenemase (MBL/NDM) produced Klebsiella pneumoniae in patients hospitalized and treated in Mazowiecki Memorial Hospital of Radom between 2016-2018.

Material and methods
The study group included 120 patients aged 80+/ – 17.0 years old. Epidemiologic analysis of the study group was conducted.

Results
The number of patients positive towards Klebsiella pneumoniae MBL was: 57 (47,5%) in 2016, 32 (26,6%) in 2017 and 31 (25,8%) in 2018. The study group included 44 women (36,67%) and 76 men (63,33%) (p<0,005). In clinically significant material 60 bacterial strains were identified, with similar frequency from lower respiratory tract discharge and from urine. Symptomatic infections in 60 patients (50%) and asyptomatic carrier in 60 patients (50%) were confirmed. Symptomatic infections from lower respiratory tract were more frequent than urinary tract infections (p=0,037), wound infections (p<0,001), generalized infections (p<0,001) and digestive tract infections (p<0,001). During 2016-2018 reduction in sensitivity of Klebsiella pneumoniae MBL strains for colistin (100%; 46,5%; 45,8%) and amikacin (72,8%; 80,8%; 45,8%) was observed.

Conclusions
1. In hospitalized patients positive towards Klebsiella pneumoniae MBL asymptomatic carrier and symptomatic infections occured with similar frequency. 2. In hospitalized patients Klebsiella pneumoniae MBL strains were most frequently identified from respiratory tract and from urinary tract. 3. Commonly with elongation of periode, then colistin and amikacin were used, the reduction of bacterial sensitivity for these antibiotics was observed.