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01.12.2017 | Research article | Ausgabe 1/2017 Open Access

BMC Infectious Diseases 1/2017

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

Zeitschrift:
BMC Infectious Diseases > Ausgabe 1/2017
Autoren:
Hui Zhang, Qiwen Yang, Kang Liao, Yuxing Ni, Yunsong Yu, Bijie Hu, Ziyong Sun, Wenxiang Huang, Yong Wang, Anhua Wu, Xianju Feng, Yanping Luo, Yunzhuo Chu, Shulan Chen, Bin Cao, Jianrong Su, Qiong Duan, Shufang Zhang, Haifeng Shao, Haishen Kong, Bingdong Gui, Zhidong Hu, Robert Badal, Yingchun Xu
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12879-017-2873-z) contains supplementary material, which is available to authorized users.

Abstract

Background

To evaluate in vitro susceptibilities of aerobic and facultative Gram-negative bacterial (GNB) isolates from intra-abdominal infections (IAIs) to 12 selected antimicrobials in Chinese hospitals from 2012 to 2014.

Methods

Hospital acquired (HA) and community acquired (CA) IAIs were collected from 21 centers in 16 Chinese cities. Extended spectrum beta-lactamase (ESBL) status and antimicrobial susceptibilities were determined at a central laboratory using CLSI broth microdilution and interpretive standards.

Results

From all isolated strains the Enterobacteriaceae (81.1%) Escherichia coli accounted for 45.4% and Klebsiella pneumoniae for 20.1%, followed by Enterobacter cloacae (5.2%), Proteus mirabilis (2.1%), Citrobacter freundii (1.8%), Enterobacter aerogenes (1.8%), Klebsiella oxytoca (1.4%), Morganella morganii (1.2%), Serratia marcescens (0.7%), Citrobacter koseri (0.3%), Proteus vulgaris (0.3%) and others (1.0%). Non- Enterobacteriaceae (18.9%) included Pseudomonas aeruginosa (9.8%), Acinetobacter baumannii (6.7%), Stenotrophomonas maltophilia (0.9%), Aeromonas hydrophila (0.4%) and others (1.1%). ESBL-screen positive Escherichia coli isolates (ESBL+) showed a decreasing trend from 67.5% in 2012 to 58.9% in 2014 of all Escherichia coli isolates and the percentage of ESBL+ Klebsiella pneumoniae isolates also decreased from 2012 through 2014 (40.4% to 26.6%), which was due to reduced percentages of ESBL+ isolates in HA IAIs for both bacteria. The overall susceptibilities of all 5160 IAI isolates were 87.53% to amikacin (AMK), 78.12% to piperacillin-tazobactam (TZP) 81.41% to imipenem (IMP) and 73.12% to ertapenem (ETP). The susceptibility of ESBL-screen positive Escherichia coli strains was 96.77%–98.8% to IPM, 91.26%–93.16% to ETP, 89.48%–92.75% to AMK and 84.86%–89.34% to TZP, while ESBL-screen positive Klebsiella pneumoniae strains were 70.56%–80.15% susceptible to ETP, 80.0%–87.5% to IPM, 83.82%–87.06% to AMK and 63.53%–68.38% to TZP within the three year study. Susceptibilities to all cephalosporins and fluoroquinolones were less than 50% beside 66.5% and 56.07% to cefoxitin (FOX) for ESBL+ Escherichia coli and Klebsiella pneumoniae strains respectively.

Conclusions

The total ESBL+ rates decreased in Escherichia coli and Klebsiella pneumoniae IAI isolates due to fewer prevalence in HA infections. IPM, ETP and AMK were the most effective antimicrobials against ESBL+ Escherichia coli and Klebsiella pneumoniae IAI isolates in 2012–2014 and a change of fluoroquinolone regimens for Chinese IAIs is recommended.
Zusatzmaterial
Additional file 1: Table S1. Bacterial identification and epidemiological status of isolates from intra-abdominal infections in China (2012–2014). (DOC 54 kb)
12879_2017_2873_MOESM1_ESM.doc
Additional file 2: Figure S1. Sources of ESBL-screen positive Escherichia coli and Klebsiella pneumoniae IAI isolates from 2012 to 2014. The upper numbers indicate the total number of isolates and the grey areas and numbers in the grey areas of the bars indicate the percentage of ESBL+ strains. (TIFF 748 kb)
12879_2017_2873_MOESM2_ESM.tif
Literatur
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