Epidemiology and antimicrobial susceptibility profiles of extended-spectrum beta-lactamase–producing Klebsiella pneumoniae and Escherichiacoli in China

Abstract

Objects The retrospective study aimed to determine the prevalence rate and antimicrobial susceptibility of extended-spectrum beta-lactamases (ESBLs)-producing Klebsiella pneumoniae and Escherichia coli in 2013-2017 at a single center in China. Methods Klebsiella pneumoniae and Escherichia coli data were collected from the microbiological laboratory. VITEK 2 compact system was used for the identification and antimicrobial susceptibility testing. ESBL status was determined as per the Clinical and Laboratory Standards Institute (CLSI) protocols microdilution method. Results Among a total of 2774 strains of Klebsiella pneumoniae and 2154 strains of Escherichia coli, 15.79% and 36.86% were found to be ESBL producers, respectively. In all patients infected by ESBLs-producing strains, those over 60 years accounted for the largest proportion. Infection by ESBLs-producing Klebsiella pneumoniae was more common in male, while that by ESBLsproducing Escherichia coli was more common in female. Urine and respiratory secretions were the most common sources of ESBLs-producing strains; however, ESBLs-producing strains from urine had been significantly declined. No carbapenemresistant isolate was found, and all ESBLs-producing strains were resistant to ceftriaxone, aztreonam, and piperacillin. There were no differences in resistance rates between ESBLs-producing Escherichia coli and Klebsiella pneumoniae to ceftazidime and cefepime; however, ESBLs-producing Klebsiella pneumoniae showed higher resistance rates to piperacillin/tazobactam, amikacin, gentamicin, and co-trimoxazole compared with ESBLs-producing Escherichia coli. Conclusion Different ESBLs-producing organisms have their own epidemiological characteristics, and the resistance of ESBLsproducing Klebsiella pneumoniae and Escherichia coli is different even to the same antibiotics. Therefore, it is important to continuously monitor the status of ESBLs-producing organisms, and an improved antimicrobial stewardship and infection control are much required.

Antimicrobial Susceptibility Profile of Extended Spectrum Beta- lactamases Producing Enterobacteriaceae isolated from clinical samples refereed to the National Bacteriology and Mycology Reference Laboratory, Ethiopia

“…Similarly, the resistance rates to trimethoprim-sulfamethoxazole in ESBLs-producing strains in this study were very high. This is not surprising among ESBL positive organisms and it was well described in various studies [37].…”

Studies on molecular epidemiology of ESβL-producing Klebsiella pneumoniae isolated from patients hospitalized in a specialist hospital in southern Poland

“…PFGE settings: Similarity coefficient: Dice, Optimization: 1%, Tolerance: 1%, Clustering method: UPGMA. most K. pneumoniae isolates that were cultured from urine (38.8%), materials from the respiratory tract (28.25%), followed by wound swabs (11.04%) and blood (7.22%) [6]. Correspondingly, most K. pneumoniae isolates characterized by Ranjbar et al came from urine (63.75%), blood (37.5%), sputum (35.21%) and wounds (33.33%) [21].…”

“…Moreover, the widespread use of antibiotics has led to the emergence of MDR strains which accumulate mechanisms conditioning resistance to various groups of antibiotics. Currently, such strains are a global problem [3,6,7,17]. Studies on molecular epidemiology of ESβL-producing K. pneumoniae isolates are needed, particularly under multi-level epidemiological monitoring, which is considered essential to understanding trans-hierarchical evolutionary changes in antibiotic resistant populations, and ultimately to establish appropriate control interventions [16].…”

“…ESβLs are β-lactamases able of conferring bacterial resistance to the penicillins; first-, second-, third-generation cephalosporins; and aztreonam (but not the cephamycins or carbapenems) by hydrolysis of these antibiotics, which are inhibited by β-lactamase inhibitors such as clavulanic acid [5]. In recent years, most ESβL-producing organisms have also been found to be resistant to other major classes of antibiotics, such as aminoglycosides, fluoroquinolones, and sulfonamides, owing to the coexistence of associated resistant genes encoded in and transmitted by plasmids [6].…”

The making of hypervirulent Klebsiella pneumoniae

“…cKP is a group of K. pneumoniae that lacks hypercapsule, macromolecular exopolysaccharide, or excessive siderophores, which incurs a high median lethality dose (LD 50 ) and rarely induces diseases in otherwise healthy individuals (except UTI) regardless of its being multidrug‐resistant (MDR). cKP often causes infections, for example, pneumonia, UTI, bacteremia, or meningitis in immunocompromised individuals 26–28 . cKP brings a LD 50 of >10 7 colony forming unit (CFU) in a BALB/c mouse pneumonia model 29 .…”