Susceptibilities of Gram-negative bacilli from hospital- and community-acquired intra-abdominal and urinary tract infections: a 2016–2017 update of the Chinese SMART study
Hui Zhang,1 Aaron Johnson,2 Ge Zhang,1 Yang Yang,1 Jingjia Zhang,1 Dongxue Li,1 Simeng Duan,1 Qiwen Yang,1 Yingchun Xu11Division of Microbiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, People’s Republic of C...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2019-04-01
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| Series: | Infection and Drug Resistance |
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| Online Access: | https://www.dovepress.com/susceptibilities-of-gram-negative-bacilli-from-hospital--and-community-peer-reviewed-article-IDR |
| _version_ | 1818339529768042496 |
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| author | Zhang H Johnson A Zhang G Yang Y Zhang J Li D Duan S Yang Q Xu Y |
| author_facet | Zhang H Johnson A Zhang G Yang Y Zhang J Li D Duan S Yang Q Xu Y |
| author_sort | Zhang H |
| collection | DOAJ |
| description | Hui Zhang,1 Aaron Johnson,2 Ge Zhang,1 Yang Yang,1 Jingjia Zhang,1 Dongxue Li,1 Simeng Duan,1 Qiwen Yang,1 Yingchun Xu11Division of Microbiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, People’s Republic of China; 2Division of Microbiology, International Health Management Associates, Schaumburg, IL 60173-3817, USAObjectives: To update the epidemiology and susceptibility of hospital-acquired (HA) and community-acquired (CA), as well as intensive care unit (ICU) vs non-ICU-derived intra-abdominal infection (IAI) and urinary tract infection (UTI) pathogens in Chinese hospitals.Methods: A total of 2,546 Gram-negative isolates from IAIs and 1,947 isolates from UTIs collected in 16 hospitals and 7 regions of China from 2016 to 2017 were analyzed.Results: E. coli and K. pneumoniae were the most common pathogens identified in HA (40.7%, 21.9%) and CA (49.2%, 21.3%) IAIs and in HA (59.0%, 17.3%) and CA (64.3%, 12.7%) UTIs, respectively. The overall rates of extended-spectrum β-lactamase (ESBL)-positive strains were 48.2% for E. coli and 26.4% for K. pneumoniae. The rates of ESBL-positive E. coli and K. pneumoniae strains were significantly higher in HA than in CA IAIs (51.7% vs 42.4%, P=0.016 and 22.0% vs 20.6%, P<0.001). IAI E. coli ESBL-producing isolates were most susceptible to IPM (97.2%) and AMK (93.9%), and UTI-associated E. coli ESBL-producers were 94.74% susceptible to amikacin (AMK), 97.02% to imipenem (IPM), and 91.4% to ertapenem (ETP). IAI K. pneumoniae ESBL-producing isolates were most susceptible to AMK (84.43%) and IPM (82.79%), and UTI-associated K. pneumoniae ESBL-producers were 88.39% susceptible to AMK, 87.5% to IPM, and 82.14% to ETP. Overall, percentages of susceptible strains to ETP, IPM, AMK, and Piperacillin-Tazobactam (TZP) were in the range of 82.0% to 96.4%, to 5 cephalosporins in the range of 31.4%-69.6% and to 2 fluoroquinolones in the range of 37.8%-45.5% for E. coli and 65.5%-90.7%, 37.7%-75.3%, and 43.9%-73.2% for K. pneumoniae, respectively.Conclusion: E. coli and K. pneumoniae continued to be the main pathogens in Chinese UTIs and IAIs with high ESBL-positive rates between 2016 and 2017. Carbapenem- or amikacin-based therapies were the most effective to combat IAI and UTI pathogens.Keywords: IAI, UTI, ESBL, E. coli, K. pneumoniae |
| first_indexed | 2024-12-13T15:28:28Z |
| format | Article |
| id | doaj.art-960a23a68f2846a49d963781360cd4d3 |
| institution | Directory Open Access Journal |
| issn | 1178-6973 |
| language | English |
| last_indexed | 2024-12-13T15:28:28Z |
| publishDate | 2019-04-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Infection and Drug Resistance |
| spelling | doaj.art-960a23a68f2846a49d963781360cd4d32022-12-21T23:40:16ZengDove Medical PressInfection and Drug Resistance1178-69732019-04-01Volume 1290591445319Susceptibilities of Gram-negative bacilli from hospital- and community-acquired intra-abdominal and urinary tract infections: a 2016–2017 update of the Chinese SMART studyZhang HJohnson AZhang GYang YZhang JLi DDuan SYang QXu YHui Zhang,1 Aaron Johnson,2 Ge Zhang,1 Yang Yang,1 Jingjia Zhang,1 Dongxue Li,1 Simeng Duan,1 Qiwen Yang,1 Yingchun Xu11Division of Microbiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, People’s Republic of China; 2Division of Microbiology, International Health Management Associates, Schaumburg, IL 60173-3817, USAObjectives: To update the epidemiology and susceptibility of hospital-acquired (HA) and community-acquired (CA), as well as intensive care unit (ICU) vs non-ICU-derived intra-abdominal infection (IAI) and urinary tract infection (UTI) pathogens in Chinese hospitals.Methods: A total of 2,546 Gram-negative isolates from IAIs and 1,947 isolates from UTIs collected in 16 hospitals and 7 regions of China from 2016 to 2017 were analyzed.Results: E. coli and K. pneumoniae were the most common pathogens identified in HA (40.7%, 21.9%) and CA (49.2%, 21.3%) IAIs and in HA (59.0%, 17.3%) and CA (64.3%, 12.7%) UTIs, respectively. The overall rates of extended-spectrum β-lactamase (ESBL)-positive strains were 48.2% for E. coli and 26.4% for K. pneumoniae. The rates of ESBL-positive E. coli and K. pneumoniae strains were significantly higher in HA than in CA IAIs (51.7% vs 42.4%, P=0.016 and 22.0% vs 20.6%, P<0.001). IAI E. coli ESBL-producing isolates were most susceptible to IPM (97.2%) and AMK (93.9%), and UTI-associated E. coli ESBL-producers were 94.74% susceptible to amikacin (AMK), 97.02% to imipenem (IPM), and 91.4% to ertapenem (ETP). IAI K. pneumoniae ESBL-producing isolates were most susceptible to AMK (84.43%) and IPM (82.79%), and UTI-associated K. pneumoniae ESBL-producers were 88.39% susceptible to AMK, 87.5% to IPM, and 82.14% to ETP. Overall, percentages of susceptible strains to ETP, IPM, AMK, and Piperacillin-Tazobactam (TZP) were in the range of 82.0% to 96.4%, to 5 cephalosporins in the range of 31.4%-69.6% and to 2 fluoroquinolones in the range of 37.8%-45.5% for E. coli and 65.5%-90.7%, 37.7%-75.3%, and 43.9%-73.2% for K. pneumoniae, respectively.Conclusion: E. coli and K. pneumoniae continued to be the main pathogens in Chinese UTIs and IAIs with high ESBL-positive rates between 2016 and 2017. Carbapenem- or amikacin-based therapies were the most effective to combat IAI and UTI pathogens.Keywords: IAI, UTI, ESBL, E. coli, K. pneumoniaehttps://www.dovepress.com/susceptibilities-of-gram-negative-bacilli-from-hospital--and-community-peer-reviewed-article-IDRIAIUTIESBLE. coliK. pneumoniae |
| spellingShingle | Zhang H Johnson A Zhang G Yang Y Zhang J Li D Duan S Yang Q Xu Y Susceptibilities of Gram-negative bacilli from hospital- and community-acquired intra-abdominal and urinary tract infections: a 2016–2017 update of the Chinese SMART study Infection and Drug Resistance IAI UTI ESBL E. coli K. pneumoniae |
| title | Susceptibilities of Gram-negative bacilli from hospital- and community-acquired intra-abdominal and urinary tract infections: a 2016–2017 update of the Chinese SMART study |
| title_full | Susceptibilities of Gram-negative bacilli from hospital- and community-acquired intra-abdominal and urinary tract infections: a 2016–2017 update of the Chinese SMART study |
| title_fullStr | Susceptibilities of Gram-negative bacilli from hospital- and community-acquired intra-abdominal and urinary tract infections: a 2016–2017 update of the Chinese SMART study |
| title_full_unstemmed | Susceptibilities of Gram-negative bacilli from hospital- and community-acquired intra-abdominal and urinary tract infections: a 2016–2017 update of the Chinese SMART study |
| title_short | Susceptibilities of Gram-negative bacilli from hospital- and community-acquired intra-abdominal and urinary tract infections: a 2016–2017 update of the Chinese SMART study |
| title_sort | susceptibilities of gram negative bacilli from hospital and community acquired intra abdominal and urinary tract infections a 2016 ndash 2017 update of the chinese smart study |
| topic | IAI UTI ESBL E. coli K. pneumoniae |
| url | https://www.dovepress.com/susceptibilities-of-gram-negative-bacilli-from-hospital--and-community-peer-reviewed-article-IDR |
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