Serious Antimicrobial Resistance Status of Pathogens Causing Hospital-acquired Lower Respiratory Tract Infections in North China

Abstract

Antimicrobial resistance patterns of pathogens causing hospital-acquired lower respiratory tract infections (LRTIs) in Shandong Province, China were investigated using data collected from January 2002 to December 2006. A total of 10 337 isolates were characterized in sputum samples from 39 920 LRTI patients: 68.72% were Gram-negative bacteria, 20.65% were Gram-positive bacteria, and 10.62% were fungi. Organisms most frequently isolated were: Pseudomonas aeruginosa (16.88%), Klebsiella pneumoniae (10.80%), Escherichia coli (10.71%), fungi (10.62%), Staphylococcus aureus (9.68%) and Acinetobacter baumannii (9.03%). Imipenem was the most effective antibiotic against Gram-negative bacteria. Most Gram-positive bacteria were susceptible to vancomycin. Susceptibility to cephalosporins was not optimal and resistance to fluoroquinolones was high. Resistance of Gram-negative bacteria showed a rapid increase over the study period, while resistance of Gram-positive bacteria remained relatively stable. The emergence of resistance to commonly prescribed antimicrobial agents used against LRTI pathogens has compounded the problem of using empirical therapy and created selective pressure on physicians to use certain antibiotics.

Microbiologic Spectrum and Antibiotic Susceptibility Pattern among Patients with Urinary and Respiratory Tract Infection

“…The importance of regional specification of RTI and UTI etiology and their antibiotic susceptibility has been convincingly proved by several studies [5, 13–18]. However, the knowledge needs to be regularly revised with changing trends in microbiological patterns of the responsible organisms [15].…”

“…Nevertheless, the trend has been different in 2007 with Pseudomonas aeruginosa being the most prevalent and Acinetobacter being the least frequent organisms. In a study by Wang et al from northern China, Pseudomonas aeruginosa was the most common isolated organism in hospitalized patients with lower respiratory tract infection [18]. However, a SENTRY antimicrobial surveillance program showed that Staphylococcus aureus comprised 28 percent of isolates followed by Pseudomonas aeruginosa in 20.0 percent, Streptococcus pneumonia in 9.1 percent, and Klebsiella saprophyticus in 7.5 percent among hospitalized patients in northern America and Canada [14].…”

“…Xia and colleagues investigated the changing pattern of isolated pathogens in lower respiratory tract infection among a Chinese population and found that Acinetobacter was more frequently isolated in 2006 than in 2010 [5] which is also confirmed by our study (15% in 2007 versus 36.8% in 2008). Moreover, it seems that Acinetobacter is commonly isolated more from ICU patients than from other wards perhaps due to the compromised immunity of the critically ill patients [5, 18]. …”

A Retrospective Analysis on Antimicrobial Sensitivity Pattern in a Medical College Hospital in Kannur District

“…Pseudomonas showed resistance to imipenem (19.4%), ceftazidime (28.1%), cefaperazone (33.7%), ciprofloxacin (71.8%), of loxacin (63.8%) and ampicillin (90.7%). 11 Among the eight positive blood samples five enterococci and three staphylococcus aureus were isolated. Enterococci showed sensitivity to vancomycin, gentamycin, ciprofloxacin, chloramphenicol, linezolid and amikacin.…”

Gram negative organisms in community acquired respiratory tract infections

“…2,8 Another study showed that in every tenth patient with community acquired pneumonia, etiology due to Gram negative bacteria had to be considered. 9 P. aeruginosa was the most commonly isolated organism of the Gram negative bacteria (32.1%).…”