Clinical Distribution Characteristics of 1439 Carbapenem-Resistant Escherichia coli Strains in China: Drug Resistance, Geographical Distribution, Antibiotic MIC50/90

Wei Zhang; Zhirong Li; Na Wang; Zhicong Yang; Jia Li; Caiqing Li; Xuying Han; Jinlu Liu; Liping Li; Shuwang Wang; Minghua Zhan

doi:10.2147/IDR.S334283

Clinical Distribution Characteristics of 1439 Carbapenem-Resistant Escherichia coli Strains in China: Drug Resistance, Geographical Distribution, Antibiotic MIC50/90

Infect Drug Resist. 2021 Nov 12:14:4717-4725. doi: 10.2147/IDR.S334283. eCollection 2021.

Authors

Wei Zhang^{1

2}, Zhirong Li³, Na Wang¹, Zhicong Yang¹, Jia Li¹, Caiqing Li¹, Xuying Han¹, Jinlu Liu¹, Liping Li⁴, Shuwang Wang⁴, Minghua Zhan^{1

5}

Affiliations

¹ Microbiology Department, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei Province, People's Republic of China.
² Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China.
³ Clinical Laboratory, Hebei Provincial Center for Clinical Laboratories, The Second Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China.
⁴ Clinical Laboratory, Zhangjiakou Xuan Gang Hospital, Zhangjiakou, Hebei Province, People's Republic of China.
⁵ Clinical Laboratory, Peking University People's Hospital, Beijing, People's Republic of China.

Abstract

Purpose: To explore the clinical distribution characteristics and antimicrobial susceptibilities of carbapenem-resistant Escherichia coli (CR-ECO) in Hebei Province, China, from 2017 to 2019, and provide data on the treatment of this bacterial infection and the prevention of its spread.

Materials and methods: A total of 1439 CR-ECO strains were collected from 2017 to 2019 in Hebei Province, China. Drug sensitivity tests were performed using the minimum inhibitory concentration (MIC) method, and the data were analyzed statistically using WHONET5.6 software.

Results: A total of 54,377 strains of Escherichia coli were isolated in Hebei Province from 2017 to 2019, of which 1439 strains were CR-ECO (2.65%). The highest proportion (33.78%) of strains was isolated from urine, and the detection rate showed a slow downward trend over the past 3 years. CR-ECO was mainly detected in densely populated and economically developed areas. Of all the patients, 54.2% were from the medical ward; the ratio of male to female patients with CR-ECO infections was 1.35:1; elderly patients and adults accounted for 59.6% and 30.8%, respectively, whereas minors and newborns accounted for 4.9% and 4.7%, respectively. For CR-ECO, the drug resistance rates to β-lactams were all higher than 80% and there was an annual increasing trend, while the drug resistance rates to quinolones remained nearly unchanged. The rate of resistance to aminoglycosides was relatively low, especially to amikacin (approximately 22%). The MIC50 of other antibacterial drugs, except amikacin, was equal to or higher than the break point of drug resistance.

Conclusion: From 2017 to 2019, the isolation rate of CR-ECO in Hebei Province, China, remained stable; however, the drug resistance rate showed an upward trend, primarily in cases of urinary tract infections in older men; the resistance rate to amikacin was the lowest.

Keywords: Enterobacteriales bacteria; MIC50/MIC90; multidrug resistance; regional distribution.

Grants and funding

This work was supported by the Youth Science and Technology Project from Department of Health of Hebei Province in China (registration number: 20180843, 20190904 and 20210702) and Key R&D project of Zhangjiakou City (2121098D, 2121064D).