Trends in Antibiotic Resistance Patterns and Burden of Escherichia Coli Infections in Young Children: A Retrospective Cross-Sectional Study in Shenzhen, China from 2014–2018

Abstract

Purpose The emergence of multi-drug resistant ESBL-producing E. coli poses a global health problem. In this study, we aimed to investigate the prevalence of E. coli infections and their antibiotic susceptibility profiles in paediatric clinical cases in Shenzhen, China from Jan 1, 2014, to Jan 30, 2019, while also determining temporal trends, identifying ESBL-producing strains, and recommending potential empirical antibiotic therapy options. Methods We isolated a total of 4148 E. coli from different specimens from a single paediatric healthcare centre. Additionally, we obtained relevant demographic data from the hospital’s electronic health records. Subsequently, we performed antimicrobial susceptibility testing for 8 classes of antibiotics and assessed ESBL production. Results Out of the 4148 isolates, 2645 were from males. The highest burden of E. coli was observed in the age group of 0–1 years, which gradually declined over the five-year study period. Antimicrobial susceptibility results indicated that 82% of E. coli isolates were highly resistant to ampicillin, followed by 52.36% resistant to cefazolin and 47.46% resistant to trimethoprim/sulfamethoxazole. Notably, a high prevalence of ESBL production (49.54%) was observed among the E. coli isolates, with 60% of them displaying a multi-drug resistance phenotype. However, it is worth mentioning that a majority of the isolates remained susceptible to ertapenem and imipenem. Our findings also highlighted a decrease in E. coli infections in Shenzhen, primarily among hospitalized patients in the 0–1 year age group. However, this decline was accompanied by a considerably high rate of ESBL production and increasing resistance to multiple antibiotics. Conclusion Our study underscores the urgent need for effective strategies to combat multi-drug resistant ESBL-producing E. coli Infections.

The Prevalence of Alert Pathogens and Microbial Resistance Mechanisms: A Three-Year Retrospective Study in a General Hospital in Poland

“…Our results correspond to the literature data on increasing levels of Gram-negative bacteria isolation (E. coli, Klebsiella spp.) in European countries, including bacteria presenting resistance mechanisms [44,45]. Also, Lagacé-Wiens et al reported significantly higher ESBL production in K. pneumoniae, E. coli, and moderately, in E. cloacae [46].…”

“…Similarly, under the Antimicrobial Testing Leadership and Surveillance (ATLAS) programme, the global prevalence of ESBL(+) E. coli was found to be 23.7% and K. pneumoniae 35.1% in 2017-2019 [50]. In retrospective studies conducted on children in Shenzhen, China (2014-2018), as much as 49.54% of E. coli strains synthesised ESBLs; however, a downward trend was observed over time [45]. In the present study, 82 of 905 E. coli isolates (9.06%) were ESBL(+), but this resistance phenotype was more commonly observed in K. pneumoniae (113 of 252 isolates; 46.03%).…”

Thought on “Isolation and Phenotypic Characterization of Virulent Bacteriophages Against Multidrug-Resistant Escherichia Coli and Its Phage-Resistant Variant from Sewage Sources” [Letter]

“… 1 The emergence of MDR- E. coli has garnered significant attention in several countries, necessitating alternative therapies to address this issue. 2 , 3 One such approach is the utilization of phage therapy. However, as highlighted by the authors in their article, the emergence of phage-resistant variants presents a new challenge, thus underscoring the perceived necessity of employing phage cocktails as a therapy strategy.…”