Abstract: Objective To analyze the distribution of resistance genes of carbapenem-resistant Klebsiella pneumoniae （CRKP） in our hospital and the relationship between resistance genes and phenotypes. The results will provide reference for clinical treatment, prevention and control. Method The non-duplicated CRKP28 strains isolated from clinical specimens were collected. The bacteria were identified and tested for drug sensitivity by VITEK-2 compact automatic microorganism identification and drug susceptibility analyzer. The whole genome sequencing technology was used for sequencing. Results 47 drug resistance genes were detected. There were 3 carbapenem resistance genes, mainly blaKPC-2 gene （25 strains,89.29%）,blaNDM-5 gene（2 strains,7.14%） and blaOXA-48 gene（1 strain, 3.57%）; Extended-spectrum β-lactamases（ESBLs） resistance genes were mainly blaTEM-1,blaSHV-28,blaCTX-M-15 and blaOXA-33, and the detection rates were 89.29%,75. 00%,75.00% and 67.86%, respectively. AAC （6 '） -Ib-cr and AAC （3） -IIa were the main aminoglycoside resistance genes,the detection rates were 71.43% and 67.86%,respectively; oqxA and AAC （6 '） -Ib-cr were the main quinolone resistance genes, and the positive rates were 85.71% and 71.43%,respectively. Among them, 20 CRKP strains carried both oqxA and AAC （6 '） -Ib-cr; FosA6 was the resistant gene to fosfomycin, and the positive rate was 100%. There were three sulfonamides resistance genes, mainly sul2 and sul1,and the detection rates were 21.43% and 17.86%,respectively. The drug resistance of 28 strains of CRKP to carbapenems,cephalosporins, quinolones and β-lactams/β-lactamase inhibitor mixture was 100%; The resistant rate to amikacin was 14.29%,and no resistant strain to tigecycline was found. The resistance phenotype and genotypes of 28 strains of CRKP were completely consistent with the tested β-lactam antibiotics. Conclusion CRKP isolates from our hospital carry multiple antimicrobial resistance genes, showing a pan-resistant phenotype. The resistance phenotype and resistance genotype have a high consistency.

Key words: Klebsiella pneumonia, Extended-spectrum β-lactamases;, Resistance gene, Whole genome sequencing