Resistance reported from China antimicrobial surveillance network (CHINET) in 2018

Hu, Fupin; Guo, Yan; Yang, Yang; Zheng, Yonggui; Shi, Wei; Jiang, Xiaofei; Zhu, Demei; Wang, Fu

doi:10.1007/s10096-019-03673-1

Cited by 235 publications

(242 citation statements)

References 4 publications

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“…Different from A. baumannii, P. aeruginosa was more sensitive to common antimicrobial agents, except ticarcillin clavulanic acid and minocycline, which were more than 50%. This is consistent with previously reported data from China [1][2]11]. For K. pneumoniae, although ESBLs producing strain was decreasing, CR-KPN was increasing signi cantly.…”

Section: Discussionsupporting

confidence: 93%

“…The results of this study showed that A. baumannii was less sensitive to common antibiotics, except for tegacyclin and minocycline, which were more than 30%. Our results were consistent with those of China antimicrobial surveillance network (CHINET) in 2018, which indicated that 16566 strains of A. baumannii from the respiratory tract were more than 50% resistant to antibiotics other than tegacyclin, minocycline and polymyxin [11]. Different from A. baumannii, P. aeruginosa was more sensitive to common antimicrobial agents, except ticarcillin clavulanic acid and minocycline, which were more than 50%.…”

Section: Discussionsupporting

confidence: 88%

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Pathogenic Characteristics of Sputum and Bronchoalveolar Lavage Fluid Samples from Patients with Lower Respiratory Tract Infection

Peng

Zhou

Tian

2020

Preprint

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Background Lower respiratory tract infections(LRIs)were a very common disease, no matter in community acquired infection or hospital acquired infection. Sputum and bronchoalveolar lavage fluid (BALF) were the most important specimens of LRIs. The choice of antibiotics for the treatment of LRIs usually depended on the results of antimicrobial sensitivity of bacteria isolated from sputum and BALF. However, it was rarely reported to compare the pathogens isolated from sputum and BALF and the difference of antimicrobial sensitivity.Methods A retrospective study was conducted to analyze the differences between sputum and BALF samples in pathogen isolation and antimicrobial sensitivity in our hospital.Results In our hospital during 2013–2015 year, the quality evaluation of sputum samples was not conducted before sputum culture, but in 2016–2018 year, the quality evaluation of sputum samples was conducted firstly and only qualified sputum samples were cultured. The results of pathogen culture showed that Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus and Haemophilus influenzae were the top five pathogens isolated from sputum and BALF. Antimicrobial susceptibility test showed for these five pathogens the susceptibility rates of BALF isolates to most antibiotics were higher than those isolated from sputum. The sensitivity of A. baumannii to common antibiotics was less than 50%. In particular, the detection rate of carbapenem resistant A. baumannii (CR-ABA) in sputum and BALF was higher than 80%. The sensitivity of P. aeruginosa to antibiotics other than ticarcillin/clavulanic acid and minocycline were higher than 50%. The detection rate of carbapenem resistant Klebsiella pneumoniae (CR-KPN) was 10% − 20% in 2013–2015 and 30% − 50% in 2016–2018. The detection rate of MRSA in sputum was higher than 80%, while that in BALF was 65% − 70%. The separation rate of beta-lactamase-negative ampicillin-resistant H. influenzae (BLNAR) was between 0–6%.Conclusions The sensitivity of strains isolated from BALF to commonly used antibiotics was generally higher than that from sputum. MRSA, CR-KPN and A. baumannii were the focus of infection control for LRIs.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 88%

Pathogenic Characteristics of Sputum and Bronchoalveolar Lavage Fluid Samples from Patients with Lower Respiratory Tract Infection

Peng

Zhou

Tian

2020

Preprint

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“…Carbapenem-Resistant Enterobacteriaceae (CRE) has emerged as a major public health threat worldwide, with very few available effective treatment options. Over the past decade in China, the annual isolation rate of CRKP steadily increased, from 3.0% in 2005 to 20.9% in 2017, ranking rst among the isolated CRE, followed by E. coli and Enterobacter cloacae (1,2). Immunocompromised hosts, especially patients with hematologic malignancies, are at increased risk for CRKP infection due to the chemotherapy-induced gastrointestinal mucositis, myelosuppression after chemotherapy, prolonged hospital stays and frequent exposure to broad-spectrum antimicrobial therapy (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics and Risk Factors for Bloodstream Infection due to Carbapenem-Resistant Klebsiella Pneumoniae in Patients with Hematologic Malignancies

Zhang

Wang

et al. 2020

Preprint

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Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) associated infections are a major threat to patient safety. Methods: A single-center, retrospective case-control study representing 734 patients with hematologic malignancies between January 1, 2017 and December 31, 2018 was conducted. Demographic and clinical data were collected from the hospital electronic medical records system. Results: Among the 734 patients with hematologic malignancies, 3% (22/734) of the patients developed CRKP BSI during their hospitalization. Overall 28-day all-cause mortality reached 77.3% (17/22). Patients with Pitt Bacteremia Score (PBS) >4, pneumonia and septic shock were more frequent in the non-survivors versus the survivors . Compared with the non-survivors in antimicrobial treatment, combination therapy of tigecycline and polymyxin B was more common in the survivors. The independent risk factors associated with CRKP BSI were CRKP rectal colonization (OR,11.067; CI=4.43-27.644; P<0.001; 3 points), severe neutropenia (OR,4.095; CI=0.876-19.141; P=0.073; 1 point) and invasive mechanical ventilation (IMV) within the previous 30 days to onset of BSI (OR,18.444; CI=1.787-190.343; P=0.014; 4 points). The total risk score of ≥5 indicated that the probability of CRKP BSI occurrence was above 48%. Conclusions: CRKP BSI in patients with hematologic malignancies is associated with high mortality. The risk factor–based prediction model might help clinicians to start prompt effective anti-infective therapy in patients with suspicion of CRKP BSI and improve outcomes. Keywords: Carbapenem-resistant Klebsiella pneumoniae ; bloodstream infection; hematologic malignancy; risk factors; prediction

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“…But unreasonable use of antibiotics leads to the emergence of CR-GNB, which is becoming more and more serious, and the treatment of some drug-resistant infections is extremely limited [9,24,25].…”

Section: Discussionmentioning

confidence: 99%

“…In China, the four major Gram-negative bacterial species were Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa according to CHINET surveillance in 2018 [9]. The resistance rate of E. coli, K. pneumoniae, A. baumannii and P. aeruginosa was fluctuated around 2.0%-2.1%, 25%-26.3%, 77.1%-78.1% and 25.8%-30.7%, respectively [9].…”

mentioning

confidence: 99%

Previous use of quinolones was not significantly correlated with antibiotic-induced carbapenem-resistant Gram-negative bacilli in China: a retrospective cohort study

Chen

Xiang

et al. 2020

Preprint

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Background: Increasing resistance to carbapenem, particularly common in Gram-negative bacilli (GNB), has become a growing public health concern around the world. The objective of this study was to investigate risk factors associated with antibiotic-induced carbapenem-resistant Gram-negative bacilli (CR-GNB) among inpatients.Methods: A retrospective cohort study was conducted in one of the largest tertiary A-level hospitals including patients with GNB cultured from any of the clinical specimens who had been admitted for more than 2 calendar days from January 2017 to June 2019. Kaplan-Meier analysis and Cox proportional hazard model were used to estimate the hazard of CR-GNB induction by antibiotics.Results: 2490 patients including 7 cohorts were included. After cox proportional risk model analysis, carbapenem, β-lactamase inhibitor, and cephalosporin had significantly higher hazards than other types of antimicrobial (P<0.001). But even without using any antimicrobials, the hazard would increase with the length of hospital stay. On multivariate analysis, carbapenem was the most principal hazard factor for antibiotic-induced CR-GNB (hazard ratio [HR], 2.968; 95% confidence interval [CI], 1.706 5.162), followed by ICU admission (HR, 1.815; 95% CI, 1.507 2.186), cephalosporin (HR, 1.605; 95% CI, 1.288 1.999), tracheotomy (HR, 1.563; 95% CI, 1.251 1.952) and β-lactamase inhibitor (HR, 1.542; 95% CI, 1.237 1.921). However, quinolone effects on antibioticinduced CR-GNB were not statistically significant.Conclusions: Prior carbapenem was a strongly risk factor for antibiotic-induced CR-GNB, but quinolone was not associated with that. Rational use of carbapenems should be implemented and antimicrobial stewardship policies should be adjusted according to the characteristics of each hospital.

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Resistance reported from China antimicrobial surveillance network (CHINET) in 2018

Cited by 235 publications

References 4 publications

Pathogenic Characteristics of Sputum and Bronchoalveolar Lavage Fluid Samples from Patients with Lower Respiratory Tract Infection

Pathogenic Characteristics of Sputum and Bronchoalveolar Lavage Fluid Samples from Patients with Lower Respiratory Tract Infection

Clinical Characteristics and Risk Factors for Bloodstream Infection due to Carbapenem-Resistant Klebsiella Pneumoniae in Patients with Hematologic Malignancies

Previous use of quinolones was not significantly correlated with antibiotic-induced carbapenem-resistant Gram-negative bacilli in China: a retrospective cohort study

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