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

    作者

    Zhang, H;Yang, QW;Liao, K;Ni, YX;Yu, YS;Hu, BJ;Sun, ZY;Huang, WX;Wang, Y;Wu, AH;Feng, XJ;Luo, YP;Chu, YZ;Chen, SL;Cao, B;Su, JR;Duan, Q;Zhang, SF;Shao, HF;Kong, HS;Gui, BD;Hu, ZD;Badal, R;Xu, YC

    作者单位

    [Zhang, Hui; Yang, Qiwen; Xu, Yingchun] Chinese Acad Med Sci, Peking Union Med Coll, Peking Union Med Coll Hosp, Div Microbiol, 1 Shuaifuyuan,Wangfujing St, Beijing 100730, Peoples R China.;-;[Liao, Kang] Sun Yat Sen Univ, Affiliated Hosp 1, Div Microbiol, Guangzhou 510080, Guangdong, Peoples R China.;-;[Ni, Yuxing] Shanghai Jiao Tong Univ, Sch Med, Ruijin Hosp, Div Microbiol, Shanghai 200025, Peoples R China.;-;[Yu, Yunsong] Zhejiang Univ, Sch Med, SirRunRun Shaw Hosp, Dept Infect Dis, Hangzhou 310016, Zhejiang, Peoples R China.;-;[Hu, Bijie] Fudan Univ, Zhongshan Hosp, Div Microbiol, Shanghai 200032, Peoples R China.;-;[Sun, Ziyong] Huazhong Univ Sci & Technol, Tongji Med Coll, Tongji Hosp, Dept Lab Med, Wuhan 430030, Hubei, Peoples R China.;-;[Huang, Wenxiang] Chongqing Med Univ, Affiliated Hosp 1, Div Microbiol, Chongqing 400016, Peoples R China.;-;[Wang, Yong] Shandong Univ, Shandong Prov Hosp, Dept Lab Med, Jinan 250021, Shandong, Peoples R China.;-;[Wu, Anhua] Cent S Univ, Xiangya Hosp, Infect Control Ctr, Changsha 410008, Hunan, Peoples R China.;-;[Feng, Xianju] Zhengzhou Univ, Affiliated Hosp 1, Div Microbiol, Zhengzhou 450052, Peoples R China.;-;[Luo, Yanping] Chinese Peoples Liberat Army Gen Hosp, Dept Microbiol, Beijing 100853, Peoples R China.;-;[Chu, Yunzhuo] Chinese Med Univ, Affiliated Hosp 1, Div Microbiol, Shenyang 110001, Peoples R China.;-;[Chen, Shulan] Harbin Med Univ, Affiliated Hosp 1, Div Microbiol, Harbin 150001, Heilongjiang, Peoples R China.;-;[Cao, Bin] China Japan Friendship Hosp, Clin Microbiol & Infect Dis Lab, Dept Resp & Crtical Care Med, Beijing 100029, Peoples R China.;-;[Su, Jianrong] Capital Med Univ, Dept Clin Lab, Beijing Friendship Hosp, Beijing 100020, Peoples R China.;-;[Duan, Qiong] Jilin Prov Peoples Hosp, Microbiol Lab, Changchun 130021, Peoples R China.;-;[Zhang, Shufang] Haikou Peoples Hosp, Div Microbiol, Haikou 570208, Hainan, Peoples R China.;-;[Shao, Haifeng] Gen Hosp Nanjing Mil Command, Div Microbiol, Nanjing 210002, Jiangsu, Peoples R China.;-;[Kong, Haishen] Zhejiang Univ, Affiliated Hosp 1, Dept Microbiol, Hangzhou 310003, Zhejiang, Peoples R China.;-;[Gui, Bingdong] Nanchang Univ, Affiliated Hosp 2, Clin Lab, Nanchang 330006, Jiangxi, Peoples R China.;-;[Hu, Zhidong] Tianjin Med Univ Gen Hosp, Div Microbiol, Tianjin 300052, Peoples R China.;-;[Badal, Robert] Int Hlth Management Associates, Div Microbiol, Schaumburg, IL 60173 USA.

    摘要

    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.

    关键词

    RESISTANCE; CONSEQUENCES; SURVEILLANCE; CARBAPENEM; HOSPITALS; THERAPY; ADULTS
基本信息

  • 所属机构:

    归属医师: 王勇

    PMID:29254478

    UT:000418160300004

    刊名:BMC INFECTIOUS DISEASES

    年,卷(期):2017年17卷

    DOI:10.1186/s12879-017-2873-z

    附件: pdf

    收录:   SCIE