Hui Zhang1, Ge Zhang1, Yang Yang1, Jingjia Zhang1, Dongxue Li1, Simeng Duan1, Qiwen Yang2, Yingchun Xu3. 1. Division of Microbiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100730, China. 2. Division of Microbiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100730, China. Electronic address: yangqiwen81@vip.163.com. 3. Division of Microbiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100730, China. Electronic address: xycpumch@139.com.
Abstract
BACKGROUND: We describe antibiotic resistance trends of Klebsiella pneumoniae pathogens, responsible for urinary tract infections (UTIs) and intra-abdominal infections (IAIs), isolated from different organs and tissues, hospital departments and Chinese regions between 2014 and 2017. METHODS: Resistances of UTIs and IAIs derived K. pneumoniae isolates from 17 hospitals in 7 Chinese regions to amikacin, imipenem, piperacillin-tazobactam, ertapenem, and cefepime were unequivocally established. RESULTS: Overall resistance rates of K. pneumoniae IAI isolates obtained from gallbladder and abscesses increased to amikacin (14.29-30.95%) and for liver, gallbladder, and abscesses to imipenem (14.29-38.10%), piperacillin-tazobactam (23.81-38.10%), and ertapenem (23.81-38.10%) in 2017, but were constant (20-30%) for K. pneumoniae isolates from UTIs from 2014 to 2017. In medical and surgical ICUs, resistance rates to all tested antibiotics rose to ∼60% for IAIs, which was also reflected in higher resistance rates of hospital acquired (HA) compared to community acquired (CA) infections. In medical ICUs resistance rates increased to 50-60% for amikacin, imipenem, and ertapenem for UTI-derived K. pneumoniae isolates in 2017. Resistance rates to all tested antibiotics were highest in the east Jiangzhe region of China, being ∼60% for K. pneumoniae isolates from IAIs and 40% for K. pneumoniae isolates from UTIs to ertapenem and imipenem, as well as > 40% for piperacillin-tazobactam in 2017. CONCLUSION: In China, ICUs resistance rates to K. pneumoniae IAIs and UTIs isolates was increased in 2017 for all tested antimicrobials including carbapenems, which makes them no longer suitable for empiric treatment. In the east Jiangzhe region this was a general trend that was independent of the type of hospital department.
BACKGROUND: We describe antibiotic resistance trends of Klebsiella pneumoniae pathogens, responsible for urinary tract infections (UTIs) and intra-abdominal infections (IAIs), isolated from different organs and tissues, hospital departments and Chinese regions between 2014 and 2017. METHODS: Resistances of UTIs and IAIs derived K. pneumoniae isolates from 17 hospitals in 7 Chinese regions to amikacin, imipenem, piperacillin-tazobactam, ertapenem, and cefepime were unequivocally established. RESULTS: Overall resistance rates of K. pneumoniae IAI isolates obtained from gallbladder and abscesses increased to amikacin (14.29-30.95%) and for liver, gallbladder, and abscesses to imipenem (14.29-38.10%), piperacillin-tazobactam (23.81-38.10%), and ertapenem (23.81-38.10%) in 2017, but were constant (20-30%) for K. pneumoniae isolates from UTIs from 2014 to 2017. In medical and surgical ICUs, resistance rates to all tested antibiotics rose to ∼60% for IAIs, which was also reflected in higher resistance rates of hospital acquired (HA) compared to community acquired (CA) infections. In medical ICUs resistance rates increased to 50-60% for amikacin, imipenem, and ertapenem for UTI-derived K. pneumoniae isolates in 2017. Resistance rates to all tested antibiotics were highest in the east Jiangzhe region of China, being ∼60% for K. pneumoniae isolates from IAIs and 40% for K. pneumoniae isolates from UTIs to ertapenem and imipenem, as well as > 40% for piperacillin-tazobactam in 2017. CONCLUSION: In China, ICUs resistance rates to K. pneumoniae IAIs and UTIs isolates was increased in 2017 for all tested antimicrobials including carbapenems, which makes them no longer suitable for empiric treatment. In the east Jiangzhe region this was a general trend that was independent of the type of hospital department.