A 10 year surveillance for antimicrobial susceptibility of Escherichia coli and Klebsiella pneumoniae in community- and hospital-associated intra-abdominal infections in China

Author:

Yang Qiwen1,Zhang Hui1,Wang Yao1,Xu Yingchun1,Chen Minjun1,Badal Robert E.2,Wang Hui3,Ni Yuxing4,Yu Yunsong5,Hu Bijie6,Sun Ziyong7,Huang Wenxiang8,Wang Yong9,Wu Anhua10,Feng Xianju11,Liao Kang12,Shen Dingxia13,Hu Zhidong14,Chu Yunzhuo15,Lu Juan16,Cao Bin17,Su Jianrong18,Gui Bingdong19,Duan Qiong20,Zhang Shufang21,Shao Haifeng22,Kong Haishen23,Hu Yunjian24,Ye Huifen25

Affiliation:

1. Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China

2. International Health Management Associates, Inc., Schaumburg, Illinois 60173-3817, USA

3. People’s Hospital of Peking University, Beijing 100044, China

4. Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025, China

5. Sir RunRun Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China

6. Zhong Shan Hospital of Fu Dan University, Shanghai 200032, China

7. Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

8. First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

9. Shandong Provincial Hospital, Jinan 250021, China

10. Xiangya Hospital, Central Southern University, Changsha 410008, China

11. First Affiliated Hospital of Zhengzhou University, Zhenzhou 450052, China

12. First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China

13. General Hospital of PLA, Beijing 100853, China

14. General Hospital of Tianjin Medical University, Tianjing 300052, China

15. First Affiliated Hospital of Chinese Medical University, Shenyang 110001, China

16. First Affiliated Hospital of Harbin Medical University, Harbin 150001, China

17. Chaoyang Hospital of Capital Medical College, Beijing 100020, China

18. Friendship Hospital of Capital Medical College, Beijing 100020, China

19. Second Affiliated Hospital of Nanchang University, Nanchang 330006, China

20. People’s Hospital of Jilin Province, Jilin 130021, China

21. People’s Hospital of Haikou City, Haikou 570208, China

22. General Hospital of Nanjing Military Command, Nanjing 210002, China

23. First Affiliated Hospital of Zhejiang University, Hangzhou 310003, China

24. Beijing Hospital, Beijing 100730, China

25. Guangzhou First Municipal People’s Hospital, Guangzhou 510180, China

Abstract

The objective of this study was to investigate the susceptibility of hospital-associated (HA) and community-associated (CA) Escherichia coli and Klebsiella pneumoniae isolated from patients with intra-abdominal infections (IAIs) in China. From 2002 to 2011, the minimum inhibitory concentrations (MICs) of 12 antibiotics against 3074 E. coli and 1025 K. pneumoniae from 23 centres located in 16 cities were determined by the broth microdilution method. During the 10 year study period, ertapenem, imipenem, amikacin and piperacillin-tazobactam retained high and stable activity against E. coli and K. pneumoniae isolates regardless of whether their source was HA or CA and regardless of their extended-spectrum beta-lactamase (ESBL) production. However, the susceptibility of E. coli to cephalosporins and ampicillin-sulbactam decreased dramatically during the 10 years, especially for the CA isolates. Fluoroquinolones showed low activity against E. coli. During the whole study period, the ESBL rates for E. coli isolates from IAIs increased from 36.1 % in 2002–2003 to 68.1 % in 2010–2011 (P<0.001). Correspondingly, the ESBL rates in HA isolates increased from 52.2 % in 2002–2003 to 70.0 % in 2010–2011 (P = 0.001), and in CA isolates from 19.1 % in 2002–2003 to 61.6 % in 2010–2011 (P<0.001). The ESBL-positive rate in K. pneumoniae remained between 30.1 and 39.3 % of the total isolates with no significant change during the 10 years. In conclusion, carbapenems retained the highest susceptibility rates against HA and CA E. coli and K. pneumoniae. High prevalence of ESBL in HA E. coli and fast-growing resistance in CA E. coli severely limit the empirical use of the third- and fourth-generation cephalosporins in the therapy of IAIs.

Publisher

Microbiology Society

Subject

Microbiology (medical),General Medicine,Microbiology

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