title: A 10 year surveillance for antimicrobial susceptibility of Escherichia coli and Klebsiella pneumoniae in community- and hospital-associated intra-abdominal infections in China.
abstract: The objective of this study was to investigate the susceptibility of hospital-associated (HA) and community-associated (CA) Escherichia coli and Klebsiella pneumoniae isolated from patients with intra-abdominal infections (IAIs) in China. From 2002 to 2011, the minimum inhibitory concentrations (MICs) of 12 antibiotics against 3074 E. coli and 1025 K. pneumoniae from 23 centres located in 16 cities were determined by the broth microdilution method. During the 10 year study period, ertapenem, imipenem, amikacin and piperacillin-tazobactam retained high and stable activity against E. coli and K. pneumoniae isolates regardless of whether their source was HA or CA and regardless of their extended-spectrum beta-lactamase (ESBL) production. However, the susceptibility of E. coli to cephalosporins and ampicillin-sulbactam decreased dramatically during the 10 years, especially for the CA isolates. Fluoroquinolones showed low activity against E. coli. During the whole study period, the ESBL rates for E. coli isolates from IAIs increased from 36.1 % in 2002-2003 to 68.1 % in 2010-2011 (P<0.001). Correspondingly, the ESBL rates in HA isolates increased from 52.2 % in 2002-2003 to 70.0 % in 2010-2011 (P = 0.001), and in CA isolates from 19.1 % in 2002-2003 to 61.6 % in 2010-2011 (P<0.001). The ESBL-positive rate in K. pneumoniae remained between 30.1 and 39.3 % of the total isolates with no significant change during the 10 years. In conclusion, carbapenems retained the highest susceptibility rates against HA and CA E. coli and K. pneumoniae. High prevalence of ESBL in HA E. coli and fast-growing resistance in CA E. coli severely limit the empirical use of the third- and fourth-generation cephalosporins in the therapy of IAIs.
authors.affiliation: Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Qiwen
authors.initials: Q
authors.lastname: Yang
authors.affiliation: Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Yingchun
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Minjun
authors.initials: M
authors.lastname: Chen
authors.affiliation: International Health Management Associates, Inc., Schaumburg, Illinois 60173-3817, USA.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Badal
authors.affiliation: People's Hospital of Peking University, Beijing 100044, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
authors.affiliation: Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025, China.
authors.forename: Yuxing
authors.initials: Y
authors.lastname: Ni
authors.affiliation: Sir RunRun Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China.
authors.forename: Yunsong
authors.initials: Y
authors.lastname: Yu
authors.affiliation: Zhong Shan Hospital of Fu Dan University, Shanghai 200032, China.
authors.forename: Bijie
authors.initials: B
authors.lastname: Hu
authors.affiliation: Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
authors.forename: Ziyong
authors.initials: Z
authors.lastname: Sun
authors.affiliation: First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
authors.forename: Wenxiang
authors.initials: W
authors.lastname: Huang
authors.affiliation: Shandong Provincial Hospital, Jinan 250021, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Xiangya Hospital, Central Southern University, Changsha 410008, China.
authors.forename: Anhua
authors.initials: A
authors.lastname: Wu
authors.affiliation: First Affiliated Hospital of Zhengzhou University, Zhenzhou 450052, China.
authors.forename: Xianju
authors.initials: X
authors.lastname: Feng
authors.affiliation: First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China.
authors.forename: Kang
authors.initials: K
authors.lastname: Liao
authors.affiliation: General Hospital of PLA, Beijing 100853, China.
authors.forename: Dingxia
authors.initials: D
authors.lastname: Shen
authors.affiliation: General Hospital of Tianjin Medical University, Tianjing 300052, China.
authors.forename: Zhidong
authors.initials: Z
authors.lastname: Hu
authors.affiliation: First Affiliated Hospital of Chinese Medical University, Shenyang 110001, China.
authors.forename: Yunzhuo
authors.initials: Y
authors.lastname: Chu
authors.affiliation: First Affiliated Hospital of Harbin Medical University, Harbin 150001, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Lu
authors.affiliation: Chaoyang Hospital of Capital Medical College, Beijing 100020, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Cao
authors.affiliation: Friendship Hospital of Capital Medical College, Beijing 100020, China.
authors.forename: Jianrong
authors.initials: J
authors.lastname: Su
authors.affiliation: Second Affiliated Hospital of Nanchang University, Nanchang 330006, China.
authors.forename: Bingdong
authors.initials: B
authors.lastname: Gui
authors.affiliation: People's Hospital of Jilin Province, Jilin 130021, China.
authors.forename: Qiong
authors.initials: Q
authors.lastname: Duan
authors.affiliation: People's Hospital of Haikou City, Haikou 570208, China.
authors.forename: Shufang
authors.initials: S
authors.lastname: Zhang
authors.affiliation: General Hospital of Nanjing Military Command, Nanjing 210002, China.
authors.forename: Haifeng
authors.initials: H
authors.lastname: Shao
authors.affiliation: First Affiliated Hospital of Zhejiang University, Hangzhou 310003, China.
authors.forename: Haishen
authors.initials: H
authors.lastname: Kong
authors.affiliation: Beijing Hospital, Beijing 100730, China.
authors.forename: Yunjian
authors.initials: Y
authors.lastname: Hu
authors.affiliation: Guangzhou First Municipal People's Hospital, Guangzhou 510180, China.
authors.forename: Huifen
authors.initials: H
authors.lastname: Ye
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002681:China / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D000077727:Ertapenem; D004926:Escherichia coli / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D015378:Imipenem / Q000494:pharmacology; D059413:Intraabdominal Infections / Q000453:epidemiology / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D015995:Prevalence; D047090:beta-Lactams / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D047090:beta-Lactams; D015378:Imipenem; D000077727:Ertapenem