title: Clinical features and antimicrobial resistance profiles of important Enterobacteriaceae pathogens in Guangzhou representative of Southern China, 2001-2015.
abstract: OBJECTIVE
  This surveillance aimed to investigate the antimicrobial resistance profiles of Enterobacteriaceae pathogens in Southern China during 2001-2015.
  
  
  METHODS
  A total of 6858 Enterobacteriaceae isolates were collected, including 4276 E. coli, 1992 K. pneumoniae and 590 Enterobacter spp. Disk diffusion method and minimum inhibitory concentrations method were used for susceptibility testing, with results interpreted by the CLSI (2015).
  
  
  RESULTS
  Urinary tract remained the dominant isolated site among E. coli (49.88%), whereas 53.26% K. pneumoniae and 45.25% Enterobacter spp. were from Sputum. The carbapenems maintained the highest antimicrobial activity (resistance rates <15%), followed by piperacillin-tazobactam and amikacin. Gentle increases were obtained in carbapenems-resistant K. pneumoniae and Enterobacter spp. (eg. from 4.5% to 11.2% and 3.2% to 14.5% in imipenem, repestively). The third-generation cephalosporins showed high and stable resistance among Enterobacteriaceae pathogens during the studied period, with ceftazidime as the most active third-generation cephalosporin against Enterobacteriaceae. Isolates from ICU department showed higher or similar resistance rates among Enterobacteriaceae pathogens compared to other wards.
  
  
  CONCLUSIONS
  Carbapenems are the most potent antibiotic agents against Enterobacteriaceae pathogens. Due to the complicated susceptibility profiles, prescribing guidelines should be based on the knowledge of antibiogram of pathogens.
authors.affiliation: School of Food Science and Engineering, South China University of Technology, Guangzhou 510640, China.
authors.forename: Jinhong
authors.initials: J
authors.lastname: Xie
authors.affiliation: Department of Clinical Pharmacy, College of Pharmacy, University of Tennessee Health Sciences Center, Memphis, TN 38163, USA.
authors.forename: Brian M
authors.initials: BM
authors.lastname: Peters
authors.affiliation: School of Food Science and Engineering, South China University of Technology, Guangzhou 510640, China; Guangdong Province Key Laboratory for Green Processing of Natural Products and Product Safety, Guangzhou 510640, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Li
authors.affiliation: School of Food Science and Engineering, South China University of Technology, Guangzhou 510640, China; Guangdong Province Key Laboratory for Green Processing of Natural Products and Product Safety, Guangzhou 510640, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Li
authors.affiliation: First Affiliated Hospital of Jinan University, Guangzhou 510620, China. Electronic address: guangchaoyu@126.com.
authors.forename: Guangchao
authors.initials: G
authors.lastname: Yu
authors.affiliation: School of Food Science and Engineering, South China University of Technology, Guangzhou 510640, China; Guangdong Province Key Laboratory for Green Processing of Natural Products and Product Safety, Guangzhou 510640, China; Department of Microbial Pathogenesis, School of Dentistry, University of Maryland, Baltimore, MD 21201, USA. Electronic address: zhenbo.xu@hotmail.com.
authors.forename: Zhenbo
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Department of Microbial Pathogenesis, School of Dentistry, University of Maryland, Baltimore, MD 21201, USA.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Shirtliff
mesh_terms: D000583:Amikacin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001769:Blood / Q000382:microbiology; D015780:Carbapenems / Q000494:pharmacology; D002442:Ceftazidime / Q000494:pharmacology; D002511:Cephalosporins / Q000494:pharmacology; D002681:China; D052978:Disk Diffusion Antimicrobial Tests / Q000379:methods; D024881:Drug Resistance, Bacterial; D004754:Enterobacter / Q000187:drug effects / Q000302:isolation & purification / Q000472:pathogenicity; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000302:isolation & purification* / Q000472:pathogenicity*; D004926:Escherichia coli / Q000187:drug effects / Q000302:isolation & purification / Q000472:pathogenicity; D006801:Humans; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000302:isolation & purification / Q000472:pathogenicity; D008826:Microbial Sensitivity Tests / Q000379:methods; D010397:Penicillanic Acid / Q000031:analogs & derivatives / Q000494:pharmacology; D010878:Piperacillin / Q000494:pharmacology; D000077725:Piperacillin, Tazobactam Drug Combination; D013183:Sputum / Q000382:microbiology; D014551:Urinary Tract / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D002511:Cephalosporins; D000077725:Piperacillin, Tazobactam Drug Combination; D000583:Amikacin; D010397:Penicillanic Acid; D002442:Ceftazidime; D010878:Piperacillin
keywords: Antimicrobial; Enterobacter; Enterobacteriaceae; Escherichia coli; Klebsiella pneumonia; Resistance