Antimicrobial Resistance Genotype Trend and Its Association with Host Clinical Characteristics in Respiratory Isolates ofHaemophilus influenzae

Abstract Objective: To assess clinical characteristics, outcomes and antimicrobial resistance of invasive Klebsiella pneumoniae (KP) infections in Chinese pediatric patients in hospital and community settings.Methods:This retrospective study was conducted in the nine tertiary hospitals during 2016-2018. The eligible pediatric inpatients who had KP isolated from blood and cerebrospinal fluid and had complete medical records reviewed were included. We compared the clinical characteristics, outcomes and antimicrobial resistance between community-acquired infections (CAI) and healthcare-associated infections (HAI), neonates and children old than 28 days, and carbapenem-resistant KP (CRKP) and carbapenem-sensitive KP (CSKP) infections.Result:In a total of enrolled 324 patients, 275 (84.9%) were clinically defined as HAI; 188 (58.0%) were neonates and 175 (93.5%) were attributable to HAI. The prevalence of CRKP was 35.8% (40.4% in HAI verse 10.2% in CAI, P <0.05). Hematologic malignancies (odds ratio (OR):15.52, 95% CI:1.89-127.14), prematurity (OR:37.07, 95% CI:8.29-165.84), invasive mechanical ventilation (OR:13.09, 95% CI: 1.66-103.56) were independent risk factors for HAI. Patients from rural area (OR: 2.05, 95% CI:1.22-3.43), invasive mechanical ventilation (OR:2.06, 95% CI: 1.13-3.76), previous antibiotic therapy (OR: 2.07, 95% CI:1.17-3.68) and previous hospital stay (OR: 2.18, 95% CI:1.18-4.03) were found to be associated with CRKP infections. Organ dysfunction was independently correlated with poor outcomes (OR: 2.88, 95% CI:1.25-6.60).Conclusions:Most of KP infections were healthcare-associated and the prevalence of invasive CRKP infections was high in pediatric patients in China. The continuous efforts of strengthening infection prevention control interventions are needed to reduce the health burden of severe KP infections in Chinese children.

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NDM-1-Positive K. pneumoniae at a Teaching Hospital in Southwestern China: Clinical Characteristics, Antimicrobial Resistance, Molecular Characterization, Biofilm Assay, and Virulence

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2020/9091360 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Kai Yang ◽

Shumin Liu ◽

Huanqin Li ◽

Na Du ◽

Jing Yao ◽

...

Keyword(s):

Multidrug Resistance ◽

Antimicrobial Resistance ◽

Biofilm Formation ◽

Neonatal Intensive Care ◽

Clinical Characteristics ◽

Statistical Difference ◽

Virulence Genes ◽

Control Group ◽

Carrier Rate ◽

Detection Rates

Background. The emergence of the NDM-1-positive Klebsiella pneumoniae (K. pneumoniae) strains has led to limited therapeutic options for clinical treatment. Understanding the clinical characteristics, antimicrobial resistance, biofilm assay, and the virulence genes of these isolated strains is of great significance. Methods. The polymerase chain reaction (PCR) was used to screen isolated NDM-1-positive K. pneumoniae. The clinical information of the patients was collected from medical records. The NDM-1-positive K. pneumoniae isolates were subjected to antimicrobial susceptibility testing and multilocus sequence typing. Sixty strains of NDM-1-negative K. pneumoniae isolated during the same period were collected as the control group for the virulence analysis. The virulence phenotype of the strains was preliminarily evaluated by the string test and crystal violet semiquantitative biofilm formation experiment. PCR combined with gene sequencing was used to detect common high toxicity capsule genes (K1, K2, K5, K20, K54, and K57) and common virulence-related genes (entB, ybtS, ureA, ycf, WabG, FimH, uge, iutA, KfuB, aerobactin, rmpA, magA, Alls, IrnN, and VatD). Results. In the 30 nonduplicated NDM-1-positive K. pneumoniae isolates, 43.33% (13/30) of the patients had a history of a stay in the neonatal intensive care unit (NICU). All of the isolates exhibited multidrug resistance. Nine STs were identified, 77% (10/13) strains from the NICU were ST11. The NDM-1-positive K. pneumoniae string tests were all negative, and 35% (21/60) NDM-1-negative K. pneumoniae were positive. The ratios of NDM-1-positive K. pneumoniae isolates biofilm formation ability according to strong, medium, and weak classification were 67%, 23%, and 10%, respectively. NDM-1-negative K. pneumoniae isolates were 60%, 25%, and 15%, respectively. There was no statistical difference between the two groups (t = 0.61, P=0.2723). The virulence-associated genes with more than 80% of detection rates among the 30 NDM-1-positive K. pneumoniae isolates included entB (100%, 30/30), ybtS (93.33%, 28/30), ureA (90%, 27/30), ycf (83.33%, 25/30), and wabG (90%, 27/30). KfuB and iutA were detected at prevalence of 3.33% and 13.33%. vatD, allS, iroN, aerobactin, and rmpA were not detected. In the NDM-1-negative K. pneumoniae, all other 14 virulence genes except VatD were detected. After statistical analysis, FimH, WabG, ycf, iutA, kfuB, aerobactin, rmpA, and Alls virulence genes, P<0.005, there was a statistical difference. Conclusion. NDM-1-positive K. pneumoniae exhibited multidrug resistance, MLST typing is mainly ST11, there is small clonal dissemination in the NICU in the hospital, and the NDM-1-positive K. pneumoniae virulence genes carrier rate is lower than the NDM-1-negative K. pneumoniae virulence genes carrier rate.

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Epidemiology, clinical characteristics and antimicrobial resistance patterns of community-acquired pneumonia in 1702 hospitalized children in Singapore

Respirology ◽

10.1111/j.1440-1843.2006.01036.x ◽

2007 ◽

Vol 12 (2) ◽

pp. 254-261 ◽

Cited By ~ 32

Author(s):

Wen C. CHIANG ◽

Oon H. TEOH ◽

Chia Y. CHONG ◽

Anne GOH ◽

Jenny P.L. TANG ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Clinical Characteristics ◽

Community Acquired Pneumonia ◽

Hospitalized Children ◽

Resistance Patterns

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Changes in Clinical Characteristics of Community-Acquired Acute Pyelonephritis and Antimicrobial Resistance of Uropathogenic Escherichia coli in South Korea in the Past Decade

Antibiotics ◽

10.3390/antibiotics9090617 ◽

2020 ◽

Vol 9 (9) ◽

pp. 617

Author(s):

Ki Tae Kwon ◽

Bongyoung Kim ◽

Seong-yeol Ryu ◽

Seong-Heon Wie ◽

Jieun Kim ◽

...

Keyword(s):

Escherichia Coli ◽

Antimicrobial Resistance ◽

South Korea ◽

Antibiotic Treatment ◽

Acute Pyelonephritis ◽

Clinical Characteristics ◽

Total Duration ◽

Generation Cephalosporin ◽

E Coli ◽

Almost All

This study examined changes in the clinical characteristics of community-acquired acute pyelonephritis (CA-APN) in South Korea between the period 2010–2011 and 2017–2018. We recruited all CA-APN patients aged ≥19 years who visited eight hospitals in South Korea from September 2017 to August 2018, prospectively. Data collected were compared with those from the previous study in 2010–2012, with the same design and participation from 11 hospitals. A total of 617 patients were enrolled and compared to 818 patients’ data collected in 2010–2011. Escherichia coli was the most common causative pathogen of CA-APN in both periods (87.3% vs. 86.5%, p = 0.680). E. coli isolates showed significantly higher antimicrobial resistance against fluoroquinolone (32.0% vs. 21.6%, p < 0.001), cefotaxime (33.6% vs. 8.3%, p < 0.001), and trimethoprim/sulfamethoxazole (37.5% vs. 29.2%, p = 0.013) in 2017–2018 than in 2010–2011. Total duration of antibiotic treatment increased from 16.55 ± 9.68 days in 2010–2011 to 19.12 ± 9.90 days in 2017–2018 (p < 0.001); the duration of carbapenem usage increased from 0.59 ± 2.87 days in 2010–2011 to 1.79 ± 4.89 days in 2010–2011 (p < 0.001). The median hospitalization was higher for patients in 2017–2018 than in 2010–2011 (9 vs. 7 days, p < 0.001). In conclusion, antimicrobial resistance of E. coli to almost all antibiotic classes, especially third generation cephalosporin, increased significantly in CA-APN in South Korea. Consequently, total duration of antibiotic treatment, including carbapenem usage, increased.

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