Prevalence, risk factors and molecular epidemiology of carbapenem-resistant in patients from Zhejiang, China, 2008-2018.

Carbapenem-resistant (CRKP) is emerging as a worldwide public health concern; however, the long-term molecular epidemiological surveillance of clinical CRKP in China is limited. We conducted a retrospective observational study (2008-2018) to assess the prevalence, susceptibility, risk factors and molecular epidemiology of clinical CRKP isolates. We found the prevalence of CRKP increased from 2.5%, 2008 to 15.8%, 2018. CRKP were significantly more frequent among hospitalized patients from ICU, and it was significantly more likely to be isolated from the capital city (Hangzhou) and the patients aged ≥60 years. Additionally, seasons and specimen types were associated with CRKP infections The main CRKP sequence type (ST) was ST11, and was the most prevalent gene variant. Together these data reveal an increasing incidence and resistance trends among CRKP, especially the ST11- -CRKP, in Zhejiang, during 2008-2018. Our findings are important for hospitals to limit its dissemination and optimize antibiotic administration.