Department of Respiratory Medicine, The Second Hospital of Jilin University, Changchun, Jilin Province, China.
Department of Clinical Laboratory, The Second Hospital of Jilin University, Changchun, China.
Braz J Microbiol. 2019 Jul;50(3):669-675. doi: 10.1007/s42770-019-00081-7. Epub 2019 Apr 10.
The retrospective study aimed to determine the prevalence rate and antimicrobial susceptibility of extended-spectrum beta-lactamases (ESBLs)-producing Klebsiella pneumoniae and Escherichia coli in 2013-2017 at a single center in China.
Klebsiella pneumoniae and Escherichia coli data were collected from the microbiological laboratory. VITEK 2 compact system was used for the identification and antimicrobial susceptibility testing. ESBL status was determined as per the Clinical and Laboratory Standards Institute (CLSI) protocols microdilution method.
Among a total of 2774 strains of Klebsiella pneumoniae and 2154 strains of Escherichia coli, 15.79% and 36.86% were found to be ESBL producers, respectively. In all patients infected by ESBLs-producing strains, those over 60 years accounted for the largest proportion. Infection by ESBLs-producing Klebsiella pneumoniae was more common in male, while that by ESBLs-producing Escherichia coli was more common in female. Urine and respiratory secretions were the most common sources of ESBLs-producing strains; however, ESBLs-producing strains from urine had been significantly declined. No carbapenem-resistant isolate was found, and all ESBLs-producing strains were resistant to ceftriaxone, aztreonam, and piperacillin. There were no differences in resistance rates between ESBLs-producing Escherichia coli and Klebsiella pneumoniae to ceftazidime and cefepime; however, ESBLs-producing Klebsiella pneumoniae showed higher resistance rates to piperacillin/tazobactam, amikacin, gentamicin, and co-trimoxazole compared with ESBLs-producing Escherichia coli.
Different ESBLs-producing organisms have their own epidemiological characteristics, and the resistance of ESBLs-producing Klebsiella pneumoniae and Escherichia coli is different even to the same antibiotics. Therefore, it is important to continuously monitor the status of ESBLs-producing organisms, and an improved antimicrobial stewardship and infection control are much required.
本回顾性研究旨在确定 2013 年至 2017 年期间中国某单一中心产超广谱β-内酰胺酶（ESBL）肺炎克雷伯菌和大肠埃希菌的流行率和药敏率。
从微生物实验室收集肺炎克雷伯菌和大肠埃希菌的数据。VITEK 2 compact 系统用于鉴定和药敏试验。ESBL 状态根据临床和实验室标准协会（CLSI）协议微量稀释法确定。
在总共 2774 株肺炎克雷伯菌和 2154 株大肠埃希菌中，分别有 15.79%和 36.86%为 ESBL 产酶株。所有感染 ESBL 产酶株的患者中，60 岁以上者所占比例最大。产 ESBL 肺炎克雷伯菌感染以男性为主，产 ESBL 大肠埃希菌感染以女性为主。尿液和呼吸道分泌物是 ESBL 产酶株的最常见来源；然而，尿液来源的 ESBL 产酶株已显著减少。未发现耐碳青霉烯类的分离株，所有 ESBL 产酶株均对头孢曲松、氨曲南和哌拉西林耐药。产 ESBL 大肠埃希菌和肺炎克雷伯菌对头孢他啶和头孢吡肟的耐药率无差异；然而，产 ESBL 肺炎克雷伯菌对哌拉西林/他唑巴坦、阿米卡星、庆大霉素和复方磺胺甲噁唑的耐药率高于产 ESBL 大肠埃希菌。
不同的 ESBL 产酶菌具有其自身的流行病学特征，产 ESBL 肺炎克雷伯菌和大肠埃希菌对同一类抗生素的耐药性也不同。因此，持续监测 ESBL 产酶菌的情况非常重要，需要改进抗菌药物管理和感染控制。
