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

Zhang, Hui; Yang, Qiwen; Liao, Kang; Ni, Yizhao; Yu, Yunsong; Hu, Bijie; Sun, Ziyong; Huang, Wenxiang; Wang, Yong; Wu, Anhua; Feng, Xin; Luo, Yanping; Chu, Yunzhuo; Chen, Shulan; Cao, Bin; Su, Jianrong; Duan, Qiong; Zhang, Shufang; Shao, Haifeng; Kong, Haishen; Gui, Bingdong; Hu, Zhidong; Badal, R.; Xu, Yingchun

doi:10.1186/s12879-017-2873-z

Cited by 34 publications

(27 citation statements)

References 29 publications

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“…SMART is a global multi-center abdominal infection program that mainly monitors Gram-negative bacteria and their susceptibility to antibiotics. The data showed that Enterobacteriaceae were still the major strains found in abdominal infections (2010–2014) in China, the most common types being E. coli and K. pneumoniae , which is in agreement with a previous study [ 13 ].…”

Section: Discussionsupporting

confidence: 92%

Antimicrobial susceptibilities of specific syndromes created with organ-specific weighted incidence antibiograms (OSWIA) in patients with intra-abdominal infections

Liu

2018

BMC Infect Dis

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BackgroundThe aim was to evaluate the value of organ-specific weighted incidence antibiogram (OSWIA) percentages for bacterial susceptibilities of Gram-negative bacteria (GNB) collected from intra-abdominal infections (IAIs) during SMART 2010–2014.MethodsWe retrospectively calculated the OSWIA percentages that would have been adequately covered by 12 common antimicrobials based on the bacterial compositions found in the appendix, peritoneum, colon, liver, gall bladder and pancreas.ResultsThe ESBL positive rates were 65.7% for Escherichia coli, 36.2% for Klebsiella pneumoniae, 42.9% for Proteus mirabilis and 33.1% for Klebsiella oxytoca. Escherichia coli were mainly found in the appendix (76.8%), but less so in the liver (32.4%). Klebsiella pneumoniae constituted 45.2% of the total liver pathogenic bacteria and 15.2–20.8% were found in 4 other organs, except the colon and appendix (< 10%). The percentages of Pseudomonas aeruginosa infections were higher in the gall bladder, intra-abdominal abscesses, pancreas and colon (10.2–13.2%) and least (5.4%) in the appendix. The susceptibilities of hospital acquired (HA) and community acquired (CA) IAI isolates from appendix, gall bladder and liver showed ≥80% susceptibilities to amikacin (AMK), imipenem (IPM), piperacillin-tazobactam (TZP) and ertapenem (ETP), while the susceptibility of isolates in abscesses and peritoneal fluid showed ≥80% susceptibility only to amikacin (AMK) and imipenem (IPM). In colon CA IAI isolates susceptibilities did not reach 80% for AMK and ETP, and in pancreatic IAIs susceptibilities of HA GNBs did not reach 80% to AMK, TZP and ETP, and CA GNBs to IMP and ETP. In addition, besides circa 80% susceptibility of HA and CA IAI isolates from appendix to cefoxitin (FOX), IAI isolates from all other organs had susceptibilities between 7.6 and 67.9% to all cephalosporins tested, 28.3–75.2% to fluoroquinolones and 7.6–51.0% to ampicillin-sulbactam (SAM), whether they were obtained from CA or HA infections.ConclusionThe calculated OSWIA susceptibilities were specific for different organs in abdominal infections.Electronic supplementary materialThe online version of this article (10.1186/s12879-018-3494-x) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 92%

Antimicrobial susceptibilities of specific syndromes created with organ-specific weighted incidence antibiograms (OSWIA) in patients with intra-abdominal infections

Liu

2018

BMC Infect Dis

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“…coli ST131 isolates showed high antimicrobial resistance to SXT, CIP, LEV, and CTX. In China, sulfonamides (such as SXT), β-lactams (such as CTX), and quinolones (such as CIP) are often used to cure E. coli infections; therefore, the high resistance of E. coli ST131 may be due to the frequent and inappropriate use of these antimicrobials [20][21][22].…”

Section: Discussionmentioning

confidence: 99%

Characterization of Integrons and Antimicrobial Resistance in Escherichia coli Sequence Type 131 Isolates

Huang

Lan

et al. 2020

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Background. Escherichia coli sequence type 131 (ST131) is an important multidrug-resistant extraintestinal pathogen, which can cause many kinds of infections. Integrons may play a crucial role in the dissemination of antibiotic resistance genes. e purpose of this study was to characterize the prevelance of integrons among E. coli ST131 strains in China. Methods. Eighty-three E. coli ST131 isolates were used in this study. e antibiotic susceptibility test was performed by the disk diffusion method. e presence and characterization of class 1, 2, and 3 integrons, as well as promotor of gene cassettes and other antimicrobial resistance genes, were detected by PCR and DNA sequencing. Transfer of integrons was carried out using a broth culture mating method. Clonal relatedness of E. coli ST131 isolates was analyzed by PFGE. Results. Overall, 26.5% (22/83) of the E. coli ST131 isolates carried class 1 integrons. Class 2 and 3 integrons were not found in this study. Two types of gene cassette arrays were demonstrated in this study and were as follows: dfrA17-aadA5 and aac(6′)-Ib-cr-cmlA5. Only one type of Pc promoter variant was detected among 22 integron-positive isolates (PcW). In vivo transfer of integron was successful for 9 of integron-positive E. coli ST131 isolates harboring resistance gene cassettes. Results of PFGE demonstrated that the integron-positive E. coli ST131 isolates were grouped into 12 different PFGE clusters. Conclusions. Our study showed a low prevalence of integrons was detected in E. coli ST131. Continued surveillance of this mobile genetic element should be performed to study the evolution of antibiotic resistance among E. coli ST131.

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“…Both E. coli and E. cloacae producing ESBLs are closely related to the drug resistance of antibiotics, and the same type of bacteria are likely to carry a variety of ESBLs, leading to multi-drug resistance [17,18]. Studies have also shown that there are multiple drug resistance mechanisms in E. coli and E. cloacae, which include mutations in Amp C enzymes and porin loss, which has been described in previous literatures [19,20]. However, we did not explore molucular mechanisms of resistances.…”

Section: Discussionmentioning

confidence: 79%

Antimicrobial resistance and epidemiology of ESBLs-producing Escherichia coli and Enterobacter cloacae isolates from the intensive care unit in an affiliated hospital of University, China

Chen¹,

Yang²,

Li³

2020

Preprint

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Background：Concerns are increasing over the importance of the hospital intensive care units (ICU) for the transmission of extended spectrum-β-lactamase (ESBLs) -producing Enterobacteriaceae. We reported the clinical characteristics and epidemiology of ESBLs isolates collected from a tertiary care hospital in China. Methods：Escherichia coli（E. coli）and Enterobacter cloacae （E. cloacae）isolates from ICU infection samples were isolated and identified. Antimicrobial susceptibility profiles and production of ESBLs were determined by using the disk diffusion method and the broth microdilution method. Clonality of isolates was determined by ERIC-PCR techniques. Results：From the included the 223 strains isolated from hospitalized patients with nosocomial infections in ICU during 2016 to 2018, the majority of isolates belonged to Gram-negative Enerobacteriaceae including E. coli (46.6% of all strains), and E. cloacae (46.2% of all strains). 63.25% of samples were separated from sputum or tracheal secretions. All of 207 isolates, ESBL-screen positive E. coli was 45.2% (47/104), and 44.7% (46/103) for E. cloacae. Resistance rates of ESBLs-producing E. coli and E. cloacae isolates were 95.5%-91.3% for ampicillin, 80.6%-76.1% for ampicillin/azobactam, 88.1%-28.3% for ciprofloxacin, 89.6%-15.2% for levofloxacin, 34.3%-45.7% for netilmicin, 82.1%-41.3% for compound sulfamethoxazole, 20.9%-43.5% for amikacin, 58.2%-37.0% for gentamicin, 20.9%-69.6% for piperacillin/tazobactam. All of ESBLs-producer isolates resistant to cefazolin, cefuroxime, ceftazidime, ceftriaxone, cefepime in additon to aztreonam were 100%, whereas the susceptibilities of isolates to imipenem and meropenem were 100%. Results of ERIC-PCR in all of ESBLs-producing E. coli isolates exhibited 11 distinct patterns using a similarity coefficient of 0.8. And one distinct ERIC profiles were observed amongst 46 strains of ESBLs-producing E. cloacae. ERIC profiles demonstrated an outbreak of nosocomial infection and ESBLs-producing E. coli and E. cloacae prevalent in the ICU of this hospital.Conclusions：Our data indicate that the ESBLs-producing E. coli and E. cloacae clones are circulating in the ICU and constitute a major source for further disseminating in this hospital. It is necessary to increase surveillance and development of adequate prevention strategies.

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

Cited by 34 publications

References 29 publications

Antimicrobial susceptibilities of specific syndromes created with organ-specific weighted incidence antibiograms (OSWIA) in patients with intra-abdominal infections

Antimicrobial susceptibilities of specific syndromes created with organ-specific weighted incidence antibiograms (OSWIA) in patients with intra-abdominal infections

Characterization of Integrons and Antimicrobial Resistance in Escherichia coli Sequence Type 131 Isolates

Antimicrobial resistance and epidemiology of ESBLs-producing Escherichia coli and Enterobacter cloacae isolates from the intensive care unit in an affiliated hospital of University, China

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