Prevalence, risk factors and molecular epidemiology of carbapenem-resistantKlebsiella pneumoniaein patients from Zhejiang, China, 2008-2018

Carbapenem-resistantKlebsiella pneumoniae(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, andbla(KPC-2)was the most prevalent gene variant. Together these data reveal an increasing incidence and resistance trends among CRKP, especially the ST11-bla(KPC-2)-CRKP, in Zhejiang, during 2008-2018. Our findings are important for hospitals to limit its dissemination and optimize antibiotic administration.