title: Antimicrobial susceptibilities of aerobic and facultative gram-negative bacilli isolated from Chinese patients with urinary tract infections between 2010 and 2014.
abstract: The objective of this study was to investigate the distribution and susceptibility of aerobic and facultative Gram-negative bacilli isolated from Chinese patients with UTIs collected within 48 h (community acquired, CA) or after 48 h (hospital acquired, HA) of hospital admission.
  
  
  
  From 2010 to 2014, the minimum inhibitory concentrations (MICs) of 12 antibiotics for 4,332 aerobic and facultative Gram-negative bacilli, sampled in 21 hospitals in 16 cities, were determined by the broth microdilution method.
  
  
  
  Enterobacteriaceae composed 88.5% of the total isolates, with Escherichia coli (E. coli) (63.2%) the most commonly isolated species, followed by Klebsiella pneumoniae (K. pneumoniae) (12.2%). Non-Enterobacteriaceae accounted for only 11.5% of all isolates and included mainly Pseudomonas aeruginosa (P. aeruginosa) (6.9%) and Acinetobacter baumannii (A. baumannii) (3.3%). Among the antimicrobial agents tested, the susceptibility rates of E.coli to the two carbapenems, ertapenem and imipenem as well as amikacin and piperacillin-tazobactam ranged from 92.5 to 98.7%. Against K. pneumonia, the most potent antibiotics were imipenem (92.6% susceptibility), amikacin (89.2% susceptibility) and ertapenem (87.9% susceptibility). Although non-Enterobacteriaceae did not show high susceptibilities to the 12 common antibiotics, amikacin exhibited the highest in vitro activity against P. aeruginosa over the 5-year study period, followed by piperacillin-tazobactam, imipenem, ceftazidime, cefepime, ciprofloxacin, and levofloxacin. The Extended Spectrum Beta-Lactamase (ESBL) rates decreased slowly during the 5 years in E. coli from 68.6% in 2010 to 59.1% in 2014, in K. pneumoniae from 59.7 to 49.2%, and in Proteus mirabilis (P. mirabilis) from 40.0 to 26.1%. However, the ESBL rates were different in 5 regions of China (Northeast, North, East, South and Middle-China).
  
  
  
  E. coli and K. pneumonia were the major pathogens causing UTIs and carbapenems and amikacin retained the highest susceptibility rates over the 5-year study period, indicating that they are good drug choices for empirical therapies, particularly of CA UTIs in China.
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: Zhipeng
authors.initials: Z
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: Ge
authors.initials: G
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: Xinxin
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China. xuyingchunbm@163.com.
authors.forename: Yingchun
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Respiratory and Critical Care Medicine, Clinical Microbiology and Infectious Disease Lab., China-Japan Friendship Hospital, Beijing, 100029, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Cao
authors.affiliation: Department of Microbiology, The First Affiliated Hospital of Zhejiang University, Hangzhou, 310003, China.
authors.forename: Haishen
authors.initials: H
authors.lastname: Kong
authors.affiliation: Division of Microbiology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200025, China.
authors.forename: Yuxing
authors.initials: Y
authors.lastname: Ni
authors.affiliation: Department of Infectious Diseases, SirRunRun Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, China.
authors.forename: Yunsong
authors.initials: Y
authors.lastname: Yu
authors.affiliation: Department of Laboratory Medicine, 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: Division of Microbiology, Zhongshan Hospital of Fudan University, Shanghai, 200032, China.
authors.forename: Bijie
authors.initials: B
authors.lastname: Hu
authors.affiliation: Division of Microbiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
authors.forename: Wenxiang
authors.initials: W
authors.lastname: Huang
authors.affiliation: Department of Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, 250021, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Infection control center, Xiangya Hospital, Central South University, Changsha, 410008, China.
authors.forename: Anhua
authors.initials: A
authors.lastname: Wu
authors.affiliation: Division of Microbiology, The First Affiliated Hospital of Zhengzhou University, Zhenzhou, 450052, China.
authors.forename: Xianju
authors.initials: X
authors.lastname: Feng
authors.affiliation: Division of Microbiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China.
authors.forename: Kang
authors.initials: K
authors.lastname: Liao
authors.affiliation: Department of Microbiology, The Chinese PLA General Hospital, Beijing, 100853, China.
authors.forename: Yanping
authors.initials: Y
authors.lastname: Luo
authors.affiliation: Division of Microbiology, Tianjin Medical University General Hospital, Tianjing, 300052, China.
authors.forename: Zhidong
authors.initials: Z
authors.lastname: Hu
authors.affiliation: Division of Microbiology, The First Affiliated Hospital of Chinese Medical University, Shenyang, 110001, China.
authors.forename: Yunzhuo
authors.initials: Y
authors.lastname: Chu
authors.affiliation: Department of Clinical Laboratory, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Lu
authors.affiliation: Department of Clinical Laboratory, Beijing Friendship Hospital of Capital Medical University, Beijing, 100020, China.
authors.forename: Jianrong
authors.initials: J
authors.lastname: Su
authors.affiliation: Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China.
authors.forename: Bingdong
authors.initials: B
authors.lastname: Gui
authors.affiliation: Microbiology Lab, Jilin Province People's Hospital, Changchun, 130021, China.
authors.forename: Qiong
authors.initials: Q
authors.lastname: Duan
authors.affiliation: Division of Microbiology, Haikou People's Hospital, Haikou, 570208, China.
authors.forename: Shufang
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Division of Microbiology, General Hospital of Nanjing Military Command, Nanjing, 210002, China.
authors.forename: Haifeng
authors.initials: H
authors.lastname: Shao
authors.affiliation: Division of Microbiology, International Health Management Associates, Schaumburg, IL, 60173-3817, USA.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Badal
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001420:Bacteria, Aerobic / Q000187:drug effects* / Q000302:isolation & purification; D002681:China; D024881:Drug Resistance, Bacterial; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000382:microbiology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antimicrobial resistance; Carbapenems; Extended spectrum beta-lactamases (ESBLs); Urinary tract infections