Background
Methods
Patients and samples
Pathogenic examination and antibiotic susceptibility determination
Statistical analysis
Results
Patient characteristics
2008–2012 (n = 239) | 2012–2015 (n = 263) |
P
| |
---|---|---|---|
Gender | |||
Male | 169 (70.71%) | 188 (71.48%) | 0.849 |
Age (years) | 44.85 ± 14.99 | 48.05 ± 15.62 | 0.020 |
≤ 16 | 6 (2.51%) | 3 (1.14%) | 0.248 |
17–32 | 49 (20.50%) | 41 (15.59%) | 0.152 |
33–48 | 88 (36.82%) | 96 (36.50%) | 0.941 |
49–64 | 76 (31.80%) | 81 (30.80%) | 0.809 |
≥ 65 | 20 (8.37%) | 42 (15.97%) | 0.010 |
Patient location | |||
ICU | 150 (62.76%) | 123 (46.77%) | <0.001 |
Fistula location, | |||
Upper gastrointestinal | 107 (45.15%) | 98 (37.26%) | 0.073 |
Lower gastrointestinal | 106 (44.35%) | 150 (57.03%) | 0.005 |
Both | 19 (7.95%) | 15 (5.70%) | 0.317 |
Co-morbidities | |||
Hypertension | 39 (16.32%) | 57 (21.67%) | 0.128 |
Diabetes | 20 (8.37%) | 30 (11.41%) | 0.256 |
Cancer | 16 (6.69%) | 42 (15.97%) | 0.001 |
IBD | 8 (3.35%) | 16 (6.08%) | 0.151 |
Lung Injury | 33 (13.81%) | 45 (17.11%) | 0.308 |
Renal Injury | 22 (9.21%) | 44 (16.73%) | 0.013 |
30-day mortality | 66 (27.62%) | 74 (28.14%) | 0.896 |
Microbiological profile
Enterobacteriaceae antibiotic resistance
Resistance rate (%) | ||||
---|---|---|---|---|
Isolate/Antibiotics | 2008–2011 | 2012–2015 | Total | P for Trend Test |
All Escherichia coli
| ||||
AMK | 7.78 | 14.16 | 11.33 | 0.154 |
AMP | 97.92 | 96.49 | 97.14 | 0.537 |
SAM | 81.97 | 87.93 | 85.88 | 0.279 |
TZP | 23.47 | 25.00 | 24.30 | 0.795 |
CZO | 92.55 | 91.30 | 91.87 | 0.742 |
CAZ | 81.82 | 69.83 | 75.35 |
0.042
|
FEP | 75.51 | 62.07 | 68.22 |
0.035
|
IPM | 14.29 | 25.86 | 20.56 |
0.037
|
CIP | 90.16 | 79.13 | 82.95 | 0.064 |
ESBL+ | ||||
AMK | 6.78 | 12.33 | 9.85 | 0.287 |
AMP | 100.00 | 100.00 | 100.00 | – |
SAM | 77.78 | 93.15 | 88.07 |
0.020
|
TZP | 20.31 | 6.85 | 13.14 |
0.020
|
SXT | 84.21 | 73.61 | 77.27 | 0.207 |
CZO | 100.00 | 100.00 | 100.00 | – |
CAZ | 89.23 | 68.49 | 78.26 |
0.003
|
FEP | 81.25 | 60.27 | 70.07 |
0.007
|
IPM | 12.31 | 8.22 | 10.14 | 0.427 |
CIP | 86.11 | 80.82 | 82.57 | 0.494 |
ESBL- | ||||
AMK | 6.67 | 16.22 | 13.46 | 0.361 |
AMP | 88.24 | 89.74 | 89.29 | 0.867 |
SAM | 77.78 | 77.50 | 77.55 | 0.986 |
ZP | 35.29 | 57.50 | 50.88 | 0.125 |
SXT | 88.89 | 67.50 | 71.43 | 0.199 |
CZO | 58.82 | 74.36 | 69.64 | 0.245 |
CTT | 28.57 | 70.00 | 63.83 |
0.035
|
CAZ | 52.94 | 70.00 | 64.91 | 0.217 |
FEP | 52.94 | 62.50 | 59.65 | 0.501 |
IPM | 43.75 | 57.50 | 53.57 | 0.351 |
CIP | 88.89 | 77.50 | 79.59 | 0.444 |
Not all tested antibiotics are listed |
Resistance rate (%) | ||||
---|---|---|---|---|
Isolate/Antibiotics | 2008–2011 | 2012–2015 | Total | P for Trend Test |
All Klebsiella pneumonia
| ||||
AMK | 40.91 | 36.11 | 37.93 | 0.605 |
SAM | 97.14 | 85.14 | 88.99 | 0.061 |
TZP | 75.00 | 58.11 | 64.75 | 0.056 |
CTT | 60.61 | 54.79 | 56.60 | 0.576 |
CAZ | 89.80 | 78.38 | 82.93 | 0.099 |
FEP | 75.00 | 67.57 | 70.49 | 0.379 |
IPM | 65.31 | 56.76 | 60.16 | 0.343 |
CIP | 74.29 | 75.68 | 75.23 | 0.875 |
ESBL+ | ||||
AMK | 33.33 | 7.41 | 16.67 |
0.031
|
SAM | 100.00 | 89.29 | 92.11 | 0.281 |
TZP | 55.56 | 17.86 | 32.61 |
0.008
|
CTT | 12.50 | 14.81 | 14.29 | 0.869 |
CAZ | 94.44 | 71.43 | 80.43 | 0.055 |
FEP | 83.33 | 53.57 | 65.22 |
0.039
|
IPM | 38.89 | 14.29 | 23.91 | 0.056 |
CIP | 50.00 | 71.43 | 65.79 | 0.220 |
ESBL- | ||||
AMK | 40.91 | 53.33 | 49.25 | 0.339 |
SAM | 94.44 | 82.61 | 85.94 | 0.221 |
TZP | 86.36 | 82.61 | 83.82 | 0.694 |
CTT | 88.89 | 78.26 | 81.25 | 0.327 |
CAZ | 82.61 | 82.61 | 82.61 | – |
FEP | 72.73 | 76.09 | 75.00 | 0.765 |
PM | 78.26 | 82.61 | 81.16 | 0.663 |
CIP | 83.33 | 78.26 | 79.69 | 0.650 |
Not all tested antibiotics are listed |
Antimicrobial resistance of non-fermenting bacteria
Resistance rate (%) | ||||
---|---|---|---|---|
Isolate/Antibiotics | 2008–2011 | 2012–2015 | Total | P for Trend Test |
Acinetobacter baumannii | ||||
AMP | 96.43 | 100.00 | 98.55 | 0.223 |
SAM | 90.48 | 100.00 | 96.77 |
0.045
|
TZP | 96.30 | 95.00 | 95.52 | 0.801 |
SXT | 95.24 | 73.17 | 80.65 |
0.037
|
CRO | 94.44 | 100.00 | 98.31 | 0.128 |
CTX | 100.00 | 100.00 | 100.00 | – |
CAZ | 88.89 | 100.00 | 95.59 |
0.029
|
FEP | 96.30 | 100.00 | 98.53 | 0.214 |
IPM | 96.30 | 95.12 | 95.59 | 0.818 |
LVX | 66.67 | 56.10 | 60.29 | 0.383 |
CIP | 95.24 | 97.56 | 96.77 | 0.624 |
Pseudomonas aeruginosa | ||||
AMK | 31.82 | 22.22 | 25.86 | 0.418 |
SAM | 100.00 | 100.00 | 100.00 | – |
TZP | 60.87 | 33.33 | 44.07 |
0.038
|
ATM | 58.82 | 75.00 | 61.90 | 0.549 |
SXT | 100.00 | 97.22 | 98.11 | 0.488 |
CRO | 100.00 | 100.00 | 100.00 | – |
CTX | 100.00 | 100.00 | 100.00 | – |
CAZ | 69.57 | 61.11 | 64.41 | 0.508 |
FEP | 65.22 | 50.00 | 55.93 | 0.251 |
IPM | 73.91 | 58.33 | 64.41 | 0.223 |
LVX | 34.78 | 44.44 | 40.68 | 0.461 |
CIP | 38.89 | 41.18 | 40.38 | 0.873 |
Not all tested antibiotics are listed |
Antimicrobial resistance of gram-positive bacteria and fungi
Resistance rate (%) | ||||
---|---|---|---|---|
Isolate/Antibiotics | 2008–2011 | 2012–2015 | Total | P for Trend Test |
Enterococcus | ||||
AMP | 72.22 | 92.45 | 84.27 |
0.01
|
STH | 47.06 | 57.58 | 52.24 | 0.389 |
GEH | 71.74 | 79.25 | 75.76 | 0.385 |
ERY | 88.57 | 88.68 | 88.64 | 0.988 |
CIP | 89.29 | 90.57 | 90.12 | 0.854 |
CLI | 100.00 | 95.56 | 95.92 | 0.667 |
MFX | 63.64 | 91.11 | 85.71 |
0.02
|
PEN | 87.23 | 92.31 | 89.90 | 0.403 |
TCY | 74.29 | 69.23 | 71.26 | 0.609 |
VAN | 4.26 | 9.43 | 7.00 | 0.311 |
LNZ | 4.88 | 0.00 | 2.17 | 0.111 |
LVX | 77.14 | 90.38 | 85.06 | 0.089 |
Staphylococcus | ||||
OXA | 82.69 | 93.10 | 86.42 | 0.190 |
SXT | 47.62 | 24.14 | 38.03 | 0.045 |
ERY | 84.62 | 82.76 | 83.95 | 0.827 |
CIP | 73.68 | 89.66 | 83.33 | 0.147 |
CLI | 69.57 | 57.14 | 64.86 | 0.278 |
MFX | 46.34 | 37.93 | 42.86 | 0.484 |
PEN | 94.34 | 100.00 | 96.34 | 0.192 |
GEN | 71.15 | 72.41 | 71.60 | 0.904 |
TCY | 56.82 | 68.97 | 61.64 | 0.296 |
VAN | 0.00 | 0.00 | 0.00 | – |
LNZ | 0.00 | 0.00 | 0.00 | – |
LVX | 68.89 | 79.31 | 72.97 | 0.324 |
Not all tested antibiotics are listed |
Resistance rate (%) | ||||
---|---|---|---|---|
Antibiotics | 2008–2011 | 2012–2015 | Total | P for Trend Test |
FLU | 18.18 | 8.33 | 11.43 | 0.395 |
VOR | 0.00 | 8.33 | 5.71 | 0.324 |
ITR | 18.18 | 5.56 | 10.34 | 0.279 |