Qiwen Yang1, Hui Zhang1, Yunsong Yu2, Haishen Kong3, Qiong Duan4, Yong Wang5, Shufang Zhang6, Ziyong Sun7, Kang Liao8, Li Gu9, Xiaofeng Jiang10, Anhua Wu11, Wenxiang Huang12, Bin Shan13, Mei Kang14, Fupin Hu15, Hua Yu16, Weijuan Zhang17, Yingchun Xu1. 1. Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China. 2. Department of Infectious Diseases, Sir Run Run Shaw Hospital, affiliated with the Zhejiang University School of Medicine, Hangzhou, China. 3. Department of Microbiology, The First Affiliated Hospital of Zhejiang University, Hangzhou, China. 4. Microbiology Laboratory, Jilin Province People's Hospital, Changchun, China. 5. Department of Laboratory Medicine, Shandong Provincial Hospital affiliated with Shandong University, Jinan, China. 6. Division of Microbiology, Haikou People's Hospital, Haikou, China. 7. Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 8. Division of Microbiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China. 9. Microbiology Laboratory, Beijing Chao-yang Hospital, Beijing, China. 10. Department of Microbiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China. 11. Infection Control Center, Xiangya Hospital, Central South University, Changsha, China. 12. Department of Infectious Diseases, First Affiliated Hospital of Chongqing Medical University, Chongqing, China. 13. Division of Microbiology, No. 1 Affiliated Hospital of Kunming Medical University, Kunming, China. 14. Division of Microbiology, West China School of Medicine/West China Hospital of Sichuan University, Chengdu, China. 15. Division of Microbiology, Shanghai Huashan Hospital, Shanghai, China. 16. Division of Microbiology, Sichuan Province People's Hospital, Chengdu, China. 17. MRL Global Medical Affairs, MSD China, Shanghai, China.
Abstract
BACKGROUND: Considering the increasing incidence of carbapenem-resistant Enterobacteriaceae in China, this study aimed to establish the in vitro effectiveness of imipenem/relebactam (IMI/REL) on clinical Enterobacteriaceae isolates derived from intra-abdominal infections (IAIs), respiratory tract infections (RTIs), and urinary tract infections (UTIs) in China between 2015 and 2018. METHODS: In total, 8781 Enterobacteriaceae isolates from IAI, RTI, and UTI samples were collected from 22 hospitals across 7 geographic regions of China. Susceptibility to antimicrobial drugs was tested using the Clinical and Laboratory Standards Institute broth microdilution and breakpoints, and IMI/REL activity was assessed using United States Food and Drug Administration guidelines. RESULTS: In 2015-2018, the most frequently identified Enterobacteriaceae species was Escherichia coli (n = 4676 [53.3%]), followed by Klebsiella pneumoniae (n = 2949 [33.6%]) and Enterobacter cloacae (n = 542 [6.2%]). The Enterobacteriaceae isolates showed 95.2% overall susceptibility to IMI/REL, of which the susceptibility rates in isolates from IAI, RTI, and UTI were 95.8%, 91.4%, and 96.6%, respectively. Overall, the susceptibilities of both intensive care unit (ICU) and non-ICU Enterobacteriaceae isolates to colistin were 92.9%, followed by IMI/REL (90.7% [95.9%]) and amikacin (83.3% [92.3%]). In addition, IMI/REL restored 66.3% susceptibility in imipenem-nonsusceptible Enterobacteriaceae. CONCLUSIONS: Given their high in vitro susceptibility, Enterobacteriaceae infections in China should be considered for IMI/REL treatment, especially with isolates that are not susceptible to carbapenems.
BACKGROUND: Considering the increasing incidence of carbapenem-resistant Enterobacteriaceae in China, this study aimed to establish the in vitro effectiveness of imipenem/relebactam (IMI/REL) on clinical Enterobacteriaceae isolates derived from intra-abdominal infections (IAIs), respiratory tract infections (RTIs), and urinary tract infections (UTIs) in China between 2015 and 2018. METHODS: In total, 8781 Enterobacteriaceae isolates from IAI, RTI, and UTI samples were collected from 22 hospitals across 7 geographic regions of China. Susceptibility to antimicrobial drugs was tested using the Clinical and Laboratory Standards Institute broth microdilution and breakpoints, and IMI/REL activity was assessed using United States Food and Drug Administration guidelines. RESULTS: In 2015-2018, the most frequently identified Enterobacteriaceae species was Escherichia coli (n = 4676 [53.3%]), followed by Klebsiella pneumoniae (n = 2949 [33.6%]) and Enterobacter cloacae (n = 542 [6.2%]). The Enterobacteriaceae isolates showed 95.2% overall susceptibility to IMI/REL, of which the susceptibility rates in isolates from IAI, RTI, and UTI were 95.8%, 91.4%, and 96.6%, respectively. Overall, the susceptibilities of both intensive care unit (ICU) and non-ICU Enterobacteriaceae isolates to colistin were 92.9%, followed by IMI/REL (90.7% [95.9%]) and amikacin (83.3% [92.3%]). In addition, IMI/REL restored 66.3% susceptibility in imipenem-nonsusceptible Enterobacteriaceae. CONCLUSIONS: Given their high in vitro susceptibility, Enterobacteriaceae infections in China should be considered for IMI/REL treatment, especially with isolates that are not susceptible to carbapenems.