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幼儿大肠埃希菌感染的抗生素耐药模式及负担趋势:2014 - 2018年中国深圳的一项回顾性横断面研究

Trends in Antibiotic Resistance Patterns and Burden of Escherichia Coli Infections in Young Children: A Retrospective Cross-Sectional Study in Shenzhen, China from 2014-2018.

作者信息

Patil Sandip, Chen Hongyu, Chen Yunsheng, Dong Shaowei, Mai Huirong, Lopes Bruno Silvester, Liu Sixi, Wen Feiqiu

机构信息

Department of Haematology and Oncology, Shenzhen Children's Hospital, Shenzhen, Guangdong Province, People's Republic of China.

Paediatric Research Institute, Shenzhen Children's Hospital, Shenzhen, Guangdong Province, People's Republic of China.

出版信息

Infect Drug Resist. 2023 Aug 21;16:5501-5510. doi: 10.2147/IDR.S425728. eCollection 2023.

Abstract

PURPOSE

The emergence of multi-drug resistant ESBL-producing poses a global health problem. In this study, we aimed to investigate the prevalence of infections and their antibiotic susceptibility profiles in paediatric clinical cases in Shenzhen, China from Jan 1, 2014, to Jan 30, 2019, while also determining temporal trends, identifying ESBL-producing strains, and recommending potential empirical antibiotic therapy options.

METHODS

We isolated a total of 4148 from different specimens from a single paediatric healthcare centre. Additionally, we obtained relevant demographic data from the hospital's electronic health records. Subsequently, we performed antimicrobial susceptibility testing for 8 classes of antibiotics and assessed ESBL production.

RESULTS

Out of the 4148 isolates, 2645 were from males. The highest burden of was observed in the age group of 0-1 years, which gradually declined over the five-year study period. Antimicrobial susceptibility results indicated that 82% of isolates were highly resistant to ampicillin, followed by 52.36% resistant to cefazolin and 47.46% resistant to trimethoprim/sulfamethoxazole. Notably, a high prevalence of ESBL production (49.54%) was observed among the isolates, with 60% of them displaying a multi-drug resistance phenotype. However, it is worth mentioning that a majority of the isolates remained susceptible to ertapenem and imipenem. Our findings also highlighted a decrease in infections in Shenzhen, primarily among hospitalized patients in the 0-1 year age group. However, this decline was accompanied by a considerably high rate of ESBL production and increasing resistance to multiple antibiotics.

CONCLUSION

Our study underscores the urgent need for effective strategies to combat multi-drug resistant ESBL-producing Infections.

摘要

目的

产超广谱β-内酰胺酶(ESBL)的多重耐药菌的出现构成了一个全球健康问题。在本研究中,我们旨在调查2014年1月1日至2019年1月30日期间中国深圳儿科临床病例中感染的流行情况及其抗生素敏感性谱,同时确定时间趋势,识别产ESBL菌株,并推荐潜在的经验性抗生素治疗方案。

方法

我们从一家儿科医疗中心的不同标本中总共分离出4148株菌。此外,我们从医院的电子健康记录中获取了相关的人口统计学数据。随后,我们对8类抗生素进行了药敏试验并评估了ESBL的产生情况。

结果

在4148株分离菌中,2645株来自男性。在0至1岁年龄组中观察到最高的感染负担,在为期五年的研究期间逐渐下降。药敏结果表明,82%的分离菌对氨苄西林高度耐药,其次是52.36%对头孢唑林耐药,47.46%对甲氧苄啶/磺胺甲恶唑耐药。值得注意的是,在分离菌中观察到ESBL产生的高流行率(49.54%),其中60%表现出多重耐药表型。然而,值得一提的是,大多数分离菌对厄他培南和亚胺培南仍敏感。我们的研究结果还突出显示深圳的感染有所减少,主要是在0至1岁年龄组的住院患者中。然而,这种下降伴随着相当高的ESBL产生率和对多种抗生素耐药性的增加。

结论

我们的研究强调迫切需要采取有效策略来对抗产ESBL的多重耐药菌感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7643/10455885/f9ff7072cebc/IDR-16-5501-g0001.jpg

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