Antimicrobial susceptibilities of aerobic and facultative gram-negative bacilli isolated from Chinese patients with urinary tract infections between 2010 and 2014

BMC Infectious Diseases

Research Article

Bingdong Gui¹  Jianrong Su²  Ge Zhang³  Hui Zhang³  Xinxin Chen³  Yao Wang³  Qiwen Yang³  Yingchun Xu³  Zhipeng Xu³  Juan Lu⁴  Yunsong Yu⁵  Yong Wang⁶  Ziyong Sun⁷  Yanping Luo⁸  Haishen Kong⁹  Bin Cao^1,10  Haifeng Shao^1,11  Shufang Zhang^1,12  Robert E. Badal^1,13  Yuxing Ni^1,14  Yunzhuo Chu^1,15  Wenxiang Huang^1,16  Xianju Feng^1,17  Kang Liao^1,18  Zhidong Hu^1,19  Bijie Hu^2,20  Anhua Wu^2,21  Qiong Duan^2,22 

[1] Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, 330006, Nanchang, China;Department of Clinical Laboratory, Beijing Friendship Hospital of Capital Medical University, 100020, Beijing, China;Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, 100730, Beijing, China;Department of Clinical Laboratory, The First Affiliated Hospital of Harbin Medical University, 150001, Harbin, China;Department of Infectious Diseases, SirRunRun Shaw Hospital, School of Medicine, Zhejiang University, 310016, Hangzhou, China;Department of Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, China;Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430030, Wuhan, China;Department of Microbiology, The Chinese PLA General Hospital, 100853, Beijing, China;Department of Microbiology, The First Affiliated Hospital of Zhejiang University, 310003, Hangzhou, China;Department of Respiratory and Critical Care Medicine, Clinical Microbiology and Infectious Disease Lab., China-Japan Friendship Hospital, 100029, Beijing, China;Division of Microbiology, General Hospital of Nanjing Military Command, 210002, Nanjing, China;Division of Microbiology, Haikou People’s Hospital, 570208, Haikou, China;Division of Microbiology, International Health Management Associates, 60173-3817, Schaumburg, IL, USA;Division of Microbiology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, 200025, Shanghai, China;Division of Microbiology, The First Affiliated Hospital of Chinese Medical University, 110001, Shenyang, China;Division of Microbiology, The First Affiliated Hospital of Chongqing Medical University, 400016, Chongqing, China;Division of Microbiology, The First Affiliated Hospital of Zhengzhou University, 450052, Zhenzhou, China;Division of Microbiology, The First Affiliated Hospital, Sun Yat-Sen University, 510080, Guangzhou, China;Division of Microbiology, Tianjin Medical University General Hospital, 300052, Tianjing, China;Division of Microbiology, Zhongshan Hospital of Fudan University, 200032, Shanghai, China;Infection control center, Xiangya Hospital, Central South University, 410008, Changsha, China;Microbiology Lab, Jilin Province People’s Hospital, 130021, Changchun, China;

关键词: Urinary tract infections;    Extended spectrum beta-lactamases (ESBLs);    Carbapenems;    Antimicrobial resistance;   

DOI  :  10.1186/s12879-017-2296-x

 received in 2016-11-29, accepted in 2017-02-28,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe objective of this study was to investigate the distribution and susceptibility of aerobic and facultative Gram-negative bacilli isolated from Chinese patients with UTIs collected within 48 h (community acquired, CA) or after 48 h (hospital acquired, HA) of hospital admission.MethodsFrom 2010 to 2014, the minimum inhibitory concentrations (MICs) of 12 antibiotics for 4,332 aerobic and facultative Gram-negative bacilli, sampled in 21 hospitals in 16 cities, were determined by the broth microdilution method.ResultsEnterobacteriaceae composed 88.5% of the total isolates, with Escherichia coli (E. coli) (63.2%) the most commonly isolated species, followed by Klebsiella pneumoniae (K. pneumoniae) (12.2%). Non-Enterobacteriaceae accounted for only 11.5% of all isolates and included mainly Pseudomonas aeruginosa (P. aeruginosa) (6.9%) and Acinetobacter baumannii (A. baumannii) (3.3%). Among the antimicrobial agents tested, the susceptibility rates of E.coli to the two carbapenems, ertapenem and imipenem as well as amikacin and piperacillin-tazobactam ranged from 92.5 to 98.7%. Against K. pneumonia, the most potent antibiotics were imipenem (92.6% susceptibility), amikacin (89.2% susceptibility) and ertapenem (87.9% susceptibility).Although non-Enterobacteriaceae did not show high susceptibilities to the 12 common antibiotics, amikacin exhibited the highest in vitro activity against P. aeruginosa over the 5-year study period, followed by piperacillin-tazobactam, imipenem, ceftazidime, cefepime, ciprofloxacin, and levofloxacin. The Extended Spectrum Beta-Lactamase (ESBL) rates decreased slowly during the 5 years in E. coli from 68.6% in 2010 to 59.1% in 2014, in K. pneumoniae from 59.7 to 49.2%, and in Proteus mirabilis (P. mirabilis) from 40.0 to 26.1%. However, the ESBL rates were different in 5 regions of China (Northeast, North, East, South and Middle-China).ConclusionE. coli and K. pneumonia were the major pathogens causing UTIs and carbapenems and amikacin retained the highest susceptibility rates over the 5-year study period, indicating that they are good drug choices for empirical therapies, particularly of CA UTIs in China.

【 授权许可】

CC BY   
© The Author(s). 2017