Update of incidence and antimicrobial susceptibility trends of Escherichia coli and Klebsiella pneumoniae isolates from Chinese intra-abdominal infection patients

BMC Infectious Diseases

卷:17

Bingdong Gui¹  Jianrong Su²  Yunsong Yu³  Yong Wang⁴  Ziyong Sun⁵  Yanping Luo⁶  Haishen Kong⁷  Bin Cao⁸  Haifeng Shao⁹  Shufang Zhang¹⁰  Robert Badal¹¹  Qiwen Yang¹²  Hui Zhang¹²  Yingchun Xu¹²  Yuxing Ni¹³  Yunzhuo Chu¹⁴  Wenxiang Huang¹⁵  Shulan Chen¹⁶  Xianju Feng¹⁷  Kang Liao¹⁸  Zhidong Hu¹⁹  Bijie Hu²⁰  Anhua Wu²¹  Qiong Duan²² 

[1] Clinical laboratory, The Second Affiliated Hospital of Nanchang University;

[2] Department of Clinical Laboratory, Beijing Friendship Hospital of Capital Medical University;

[3] Department of Infectious Diseases, SirRunRun Shaw Hospital, School of Medicine, Zhejiang University;

[4] Department of Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University;

[5] Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology;

[6] Department of Microbiology, The Chinese PLA General Hospital;

[7] Department of Microbiology, The First Affiliated Hospital of Zhejiang University;

[8] Department of Respiratory and Crtical Care Medicine, Clinical Microbiology and Infectious Disease Laboratory, China-Japan Friendship Hospital;

[9] Division of Microbiology, General Hospital of Nanjing Military Command;

[10] Division of Microbiology, Haikou People’s Hospital;

[11] Division of Microbiology, International Health Management Associates;

[12] Division of Microbiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences;

[13] Division of Microbiology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University;

[14] Division of Microbiology, The First Affiliated Hospital of Chinese Medical University;

[15] Division of Microbiology, The First Affiliated Hospital of Chongqing Medical University;

[16] Division of Microbiology, The First Affiliated Hospital of Harbin Medical University;

[17] Division of Microbiology, The First Affiliated Hospital of Zhengzhou University;

[18] Division of Microbiology, The First Affiliated Hospital, Sun Yat-Sen University;

[19] Division of Microbiology, Tianjin Medical University General Hospital;

[20] Division of Microbiology, Zhongshan Hospital of Fudan University;

[21] Infection Control Center, Xiangya Hospital, Central South University;

[22] Microbiology Laboratory, Jilin Province People’s Hospital;

关键词: Carbapenems;    Extended spectrum beta-lactamase;    Intra-abdominal infection;    Escherichia coli;    Klebsiella pneumoniae;   

DOI  :  10.1186/s12879-017-2873-z

来源: DOAJ

【 摘 要 】

Abstract Background To evaluate in vitro susceptibilities of aerobic and facultative Gram-negative bacterial (GNB) isolates from intra-abdominal infections (IAIs) to 12 selected antimicrobials in Chinese hospitals from 2012 to 2014. Methods Hospital acquired (HA) and community acquired (CA) IAIs were collected from 21 centers in 16 Chinese cities. Extended spectrum beta-lactamase (ESBL) status and antimicrobial susceptibilities were determined at a central laboratory using CLSI broth microdilution and interpretive standards. Results From all isolated strains the Enterobacteriaceae (81.1%) Escherichia coli accounted for 45.4% and Klebsiella pneumoniae for 20.1%, followed by Enterobacter cloacae (5.2%), Proteus mirabilis (2.1%), Citrobacter freundii (1.8%), Enterobacter aerogenes (1.8%), Klebsiella oxytoca (1.4%), Morganella morganii (1.2%), Serratia marcescens (0.7%), Citrobacter koseri (0.3%), Proteus vulgaris (0.3%) and others (1.0%). Non- Enterobacteriaceae (18.9%) included Pseudomonas aeruginosa (9.8%), Acinetobacter baumannii (6.7%), Stenotrophomonas maltophilia (0.9%), Aeromonas hydrophila (0.4%) and others (1.1%). ESBL-screen positive Escherichia coli isolates (ESBL+) showed a decreasing trend from 67.5% in 2012 to 58.9% in 2014 of all Escherichia coli isolates and the percentage of ESBL+ Klebsiella pneumoniae isolates also decreased from 2012 through 2014 (40.4% to 26.6%), which was due to reduced percentages of ESBL+ isolates in HA IAIs for both bacteria. The overall susceptibilities of all 5160 IAI isolates were 87.53% to amikacin (AMK), 78.12% to piperacillin-tazobactam (TZP) 81.41% to imipenem (IMP) and 73.12% to ertapenem (ETP). The susceptibility of ESBL-screen positive Escherichia coli strains was 96.77%–98.8% to IPM, 91.26%–93.16% to ETP, 89.48%–92.75% to AMK and 84.86%–89.34% to TZP, while ESBL-screen positive Klebsiella pneumoniae strains were 70.56%–80.15% susceptible to ETP, 80.0%–87.5% to IPM, 83.82%–87.06% to AMK and 63.53%–68.38% to TZP within the three year study. Susceptibilities to all cephalosporins and fluoroquinolones were less than 50% beside 66.5% and 56.07% to cefoxitin (FOX) for ESBL+ Escherichia coli and Klebsiella pneumoniae strains respectively. Conclusions The total ESBL+ rates decreased in Escherichia coli and Klebsiella pneumoniae IAI isolates due to fewer prevalence in HA infections. IPM, ETP and AMK were the most effective antimicrobials against ESBL+ Escherichia coli and Klebsiella pneumoniae IAI isolates in 2012–2014 and a change of fluoroquinolone regimens for Chinese IAIs is recommended.

【 授权许可】

Unknown