Abstract: Objective To investigate and analyze the drug resistance and homology of carbapenem-resistant Klebsiella pneumoniae （CRKP） isolated from intensive care unit （ICU） in order to provide reference for clinical antimicrobial treatment and monitoring. Methods From March 2019 to March 2021, 260 strains of CRKP （including 156 strains from a hospital in Ma'anshan and 104 strains from a hospital in Soochow） were isolated from the ICUs of two hospitals. Routine drug sensitivity test, PCR amplification and sequencing were used to detect the drug resistance genes, homology analysis of CRKP strains was carried out by pulsed field gel electrophoresis （PFGE） and multilocus sequence typing （MLST）. Results All 260 strains of CRKP were highly resistant to 17 kinds of commonly used antibiotics, and the multiple drug resistance rate was 100%. CRKP strains isolated from the hospital in Ma'anshan mainly carried carbapenemase and extended spectrum β -Lactamases （ESBLs） gene, including five kinds of drug resistance genes. The carrying rates of bla_KPC-2, bla_NDM-1, bla_SHV, bla_TEM and bla_CTX-M-1 were 84.62%, 3.21%, 70.51%, 71.79% and 80.77% respectively. CRKP strains isolated from the hospital in Soochow carried five kinds of drug resistance genes, namely bla_KPC-2, bla_NDM-1, bla_SHV, bla_TEM and bla_CTX-M-9, the carrying rates were 74.04%, 23.08%, 80.77%, 76.92% and 27.88% respectively. PFGE typing results showed that both of CRKP strains in the two hospitals were mainly type A and type C, but the subtypes and quantity were different. According to MLST classification, 8 sequence types were identified, including ST11, ST76, ST16, ST437, ST379, ST751, ST395 and ST307. The main sequence type was ST11 in the hospital in Ma'anshan, accounting for 83.97%. While the hospital in Soochow was mainly ST11 （65.38%） and ST76 （27.88%）. Conclusion There are some differences in CRKP strains in the ICUs of two hospitals, but they are both mainly ST11 type carrying KPC-2 carbapenemase gene. Strengthening ICU cleaning and nosocomial infection monitoring is conducive to controlling the spread and prevalence of multi drug resistant bacteria.

Key words: Carbapenem-resistant Klebsiella pneumoniae, Intensive care unit, Multiple drug resistance, Homology