Abstract
ObjectiveTo investigate the incidence and susceptibilities of non-fermenting bacteria isolates from Chinese respiratory (RTI), intra-abdominal (IAI) and urinary tract (UTI) infections to antimicrobial agents between 2015 and 2017.MethodsIn total, 3,246 non-fermentative bacteria were collected from 21 hospitals and 9 hospital departments across 7 regions of China. A central testing laboratory was employed to determine antimicrobial susceptibilities using appropriate standards of interpretation.ResultsThe majority of the isolates were Acinetobacter baumannii (n = 1,360, 41.9%) and Pseudomonas aeruginosa (n = 1,341, 41.3%). Overall multidrug resistance (MDR) and carbapenem resistance (CR) rates of Acinetobacter baumannii were 80.1 and 78.7% with MDR and CR rates in RTIs, IAIs, and UTIs of 82.0 and 81.0%, 82.6 and 81.0% as well as 53.1 and 46.9%. Overall MDR and CR rates of Pseudomonas aeruginosa isolates were 36.2 and 38.9% with 41.8 and 44.3%, 29.3 and 36.1% as well as 24.2 and 20.2% MDR and CR rates in RTIs, IAIs, and UTIs. Overall susceptibility rates to imipenem, meropenem, amikacin, ciprofloxacin, cefepime and piperacillin-tazobactam were 21.1, 21.3, 33.0, 18.4, 19.2, and 19.6% for Acinetobacter baumannii and 56.5, 58.5, 88.4, 63.1, 63.1, and 55.63% for Pseudomonas aeruginosa isolates, whereas for colistin they were 95.7 and 94.6%, respectively. In all departments and regions of China, susceptibility rates of Pseudomonas aeruginosa and Acinetobacter baumannii isolates to colistin were constantly above 80%.ConclusionDue to the high MDR and CR rates for Pseudomonas aeruginosa and Acinetobacter baumannii, isolates obtained from RTIs, IAIs, and UTIs only maintained high susceptibility rates to colistin between 2015 and 2017.
Highlights
MATERIALS AND METHODSNon-fermenting bacteria are a group of aerobic or facultative anaerobic, spore-free, Gram-negative bacteria that do not use glucose or use only oxidized forms; most are conditional pathogens, which mainly cause nosocomial infections, and clinical treatment is very difficult (Mesaros et al, 2007; Perez et al, 2007)
From 2015 to 2017, a total of 3,246 non-fermentative bacteria were collected, of which P. aeruginosa and A. baumannii were major isolates of non-fermentative bacteria with similar proportions (41.3 and 41.9%, respectively), with the majority isolated from RTIs
A. baumannii, carbapenem resistance (CR) and multidrug resistant (MDR) phenotypes were found in abundance in isolates taken from the respiratory tract (81.0 and 82.0%) and in intra-abdominal infections (IAIs) (81.0 and 82.6%)
Summary
MATERIALS AND METHODSNon-fermenting bacteria are a group of aerobic or facultative anaerobic, spore-free, Gram-negative bacteria that do not use glucose or use only oxidized forms; most are conditional pathogens, which mainly cause nosocomial infections, and clinical treatment is very difficult (Mesaros et al, 2007; Perez et al, 2007). A. baumannii often causes respiratory, urinary, skin, soft tissue and bloodstream infections It is one of the main pathogens causing ventilator-associated pneumonia in the United States and Europe (Fernández-Barat et al, 2017; Koulenti et al, 2017). An investigation into healthcare associated infections in the US revealed that P. aeruginosa was the 6th most commonly found pathogen in infections as well as the 2nd most common organism causing pneumonia (Magill et al, 2014) This organism has evolved various defenses that render it resistance to various classes of antibiotics including the β-lactams; P. aeruginosa is often cited as being multidrug resistant (MDR) (Castanheira et al, 2014). This has serious consequences as antibiotic therapy to treat MDR P. aeruginosa are severely limited, in areas of China where MDR organisms are widely dispersed (Ruiz-Garbajosa and Canton, 2017; El Chakhtoura et al, 2018)
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