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Abstract：
BACKGROUND: The study aims were to evaluate the species distribution and antimicrobial resistance profile of Gram-negative pathogens isolated from specimens of intra-abdominal infections (IAI), urinary tract infections (UTI), respiratory tract infections (RTI), and blood stream infections (BSI) in emergency departments (EDs) in China.
METHODS: From 2016 to 2019, 656 isolates were collected from 18 hospitals across China. Minimum inhibitory concentrations were determined by CLSI broth microdilution and interpreted according to CLSI M100 (2021) guidelines. In addition, organ-specific weighted incidence antibiograms (OSWIAs) were constructed.
RESULTS: Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) were the most common pathogens isolated from BSI, IAI and UTI, accounting for 80% of the Gram-negative clinical isolates, while Pseudomonas aeruginosa (P. aeruginosa) was mainly isolated from RTI. E. coli showed < 10% resistance rates to amikacin, colistin, ertapenem, imipenem, meropenem and piperacillin/tazobactam. K. pneumoniae exhibited low resistance rates only to colistin (6.4%) and amikacin (17.5%) with resistance rates of 25-29% to carbapenems. P. aeruginosa exhibited low resistance rates only to amikacin (13.4%), colistin (11.6%), and tobramycin (10.8%) with over 30% resistance to all traditional antipseudomonal antimicrobials including ceftazidime, cefepime, carbapenems and levofloxacin. OSWIAs were different at different infection sites. Among them, the susceptibility of RTI to conventional antibiotics was lower than for IAI, UTI or BSI.
CONCLUSIONS: Gram-negative bacteria collected from Chinese EDs exhibited high resistance to commonly used antibiotics. Susceptibilities were organ specific for different infection sites, knowledge which will be useful for guiding empirical therapies in the clinic.
METHODS: From 2016 to 2019, 656 isolates were collected from 18 hospitals across China. Minimum inhibitory concentrations were determined by CLSI broth microdilution and interpreted according to CLSI M100 (2021) guidelines. In addition, organ-specific weighted incidence antibiograms (OSWIAs) were constructed.
RESULTS: Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) were the most common pathogens isolated from BSI, IAI and UTI, accounting for 80% of the Gram-negative clinical isolates, while Pseudomonas aeruginosa (P. aeruginosa) was mainly isolated from RTI. E. coli showed < 10% resistance rates to amikacin, colistin, ertapenem, imipenem, meropenem and piperacillin/tazobactam. K. pneumoniae exhibited low resistance rates only to colistin (6.4%) and amikacin (17.5%) with resistance rates of 25-29% to carbapenems. P. aeruginosa exhibited low resistance rates only to amikacin (13.4%), colistin (11.6%), and tobramycin (10.8%) with over 30% resistance to all traditional antipseudomonal antimicrobials including ceftazidime, cefepime, carbapenems and levofloxacin. OSWIAs were different at different infection sites. Among them, the susceptibility of RTI to conventional antibiotics was lower than for IAI, UTI or BSI.
CONCLUSIONS: Gram-negative bacteria collected from Chinese EDs exhibited high resistance to commonly used antibiotics. Susceptibilities were organ specific for different infection sites, knowledge which will be useful for guiding empirical therapies in the clinic.
摘要：
背景：该研究旨在评估从腹腔感染（IAI）标本中分离出的革兰氏阴性病原体的物种分布和耐药性，尿路感染（UTI），呼吸道感染（RTI），中国急诊科（ED）的血流感染（BSI）。
方法：2016-2019年，从全国18家医院收集656株分离株。通过CLSI肉汤微量稀释确定最小抑制浓度，并根据CLSIM100（2021）指南进行解释。此外,构建了器官特异性加权发生率抗菌谱(OSWIAs)。
结果：大肠杆菌(E.大肠杆菌)和肺炎克雷伯菌(K.肺炎)是从BSI中分离出的最常见病原体，IAI和UTI,占革兰氏阴性临床分离株的80%，而铜绿假单胞菌(P.铜绿假单胞菌）主要从RTI中分离。大肠杆菌对阿米卡星的耐药率<10%，粘菌素,厄他培南,亚胺培南,美罗培南和哌拉西林/他唑巴坦。肺炎克雷伯菌仅对粘菌素（6.4％）和阿米卡星（17.5％）的耐药率低，对碳青霉烯类抗生素的耐药率为25-29％。铜绿假单胞菌对阿米卡星耐药率低(13.4%),粘菌素(11.6%),和妥布霉素（10.8％），对包括头孢他啶在内的所有传统的抗伪单克隆抗菌药物具有超过30％的耐药性，头孢吡肟,碳青霉烯类和左氧氟沙星。OSWIA在不同的感染部位是不同的。其中,RTI对常规抗生素的敏感性低于IAI，UTI或BSI。
结论：从中国ED收集的革兰氏阴性菌对常用抗菌药物具有较高的耐药性。易感性是不同感染部位的器官特异性，这些知识将有助于指导临床经验疗法。
方法：2016-2019年，从全国18家医院收集656株分离株。通过CLSI肉汤微量稀释确定最小抑制浓度，并根据CLSIM100（2021）指南进行解释。此外,构建了器官特异性加权发生率抗菌谱(OSWIAs)。
结果：大肠杆菌(E.大肠杆菌)和肺炎克雷伯菌(K.肺炎)是从BSI中分离出的最常见病原体，IAI和UTI,占革兰氏阴性临床分离株的80%，而铜绿假单胞菌(P.铜绿假单胞菌）主要从RTI中分离。大肠杆菌对阿米卡星的耐药率<10%，粘菌素,厄他培南,亚胺培南,美罗培南和哌拉西林/他唑巴坦。肺炎克雷伯菌仅对粘菌素（6.4％）和阿米卡星（17.5％）的耐药率低，对碳青霉烯类抗生素的耐药率为25-29％。铜绿假单胞菌对阿米卡星耐药率低(13.4%),粘菌素(11.6%),和妥布霉素（10.8％），对包括头孢他啶在内的所有传统的抗伪单克隆抗菌药物具有超过30％的耐药性，头孢吡肟,碳青霉烯类和左氧氟沙星。OSWIA在不同的感染部位是不同的。其中,RTI对常规抗生素的敏感性低于IAI，UTI或BSI。
结论：从中国ED收集的革兰氏阴性菌对常用抗菌药物具有较高的耐药性。易感性是不同感染部位的器官特异性，这些知识将有助于指导临床经验疗法。
