scholarly journals Antimicrobial resistance among pathogens that infect the bloodstream: a multicenter surveillance report for 1998–2017

2020 ◽  
Author(s):  
lei tian ◽  
zhen zhang ◽  
ziyong sun

Abstract Background Bloodstream infections (BSIs) are a common consequence of infectious diseases and cause high morbidity and mortality. Appropriate antibiotic use is critical for patients’ treatment and prognosis. Long-term monitoring and analyzing of bacterial resistance are important for guiding physicians in choosing the appropriate antibiotics and understanding the changes in bacterial resistance and infection control. Here, we report a retrospective study on antimicrobial resistance in BSI-associated pathogens.Methods Data from the Hubei Province Antimicrobial Resistance Surveillance System (HBARSS) from 1998–2017 were retrospectively analyzed using WHONET 5.6 software. Results Data from HBARSS (1998–2017) revealed that 40,518 Gram-positive bacteria and 26,568 Gram-negative bacteria caused BSIs, the most common of which were Staphylococcus aureus and Escherichia coli. Drug susceptibility data showed that the resistance rates of E. coli and Klebsiella pneumoniae to cefotaxime were significantly higher than those to ceftazidime. Carbapenem-resistant (CR) E. coli and K. pneumoniae have also emerged. In 2013–2017, K. pneumoniae showed resistance levels reaching 15.8% and 17.5% to imipenem and meropenem, respectively, and Acinetobacter baumannii showed high resistance rates ranging from 60–80% to common antibiotics. Control of methicillin-resistant Staphylococcus aureus (MRSA) remains a major challenge, and in 2009–2017, the MRSA detection rate was 40–50%. Conclusions Prevalence of CR K. pneumoniae has increased significantly in recent years. Resistance rates of A. baumannii to common antimicrobial agents have increased exponentially, reaching high levels. MRSA remains a challenge to control.

2020 ◽  
Author(s):  
lei tian ◽  
zhen zhang ◽  
ziyong sun

Abstract Background Bloodstream infections (BSIs) are a common consequence of infectious diseases and cause high morbidity and mortality. Appropriate antibiotic use is critical for patients’ treatment and prognosis. Long-term monitoring and analyzing of bacterial resistance are important for understanding the changes in bacterial resistance and infection control. Here, we report a retrospective study on antimicrobial resistance in BSI-associated pathogens.Methods Data from the Hubei Province Antimicrobial Resistance Surveillance System (HBARSS) from 1998–2017 were retrospectively analyzed using WHONET 5.6 software.Results Data from HBARSS (1998–2017) revealed that 40,518 Gram-positive bacteria and 26,568 Gram-negative bacteria caused BSIs, the most common of which were Staphylococcus aureus and Escherichia coli. Salmonella typhi was a predominant BSI-associated pathogen in 1998–2003. Drug susceptibility data showed that the resistance rates of E. coli and Klebsiella pneumoniae to cefotaxime were significantly higher than those to ceftazidime. Carbapenem-resistant (CR) E. coli and K. pneumoniae have also emerged. In 2013–2017, K. pneumoniae showed resistance levels reaching 15.8% and 17.5% to imipenem and meropenem, respectively, and Acinetobacter baumannii showed high resistance rates ranging from 60–80% to common antibiotics. The detection rate of Salmonella typhi resistance to third-generation cephalosporins and fluoroquinolones was less than 5%. Control of methicillin-resistant Staphylococcus aureus (MRSA) remains a major challenge, and in 2009–2017, the MRSA detection rate was 40–50%. The number of extensively drug-resistant A. baumannii and P. aeruginosa has been increasing since 2008. From 1998 to 2017, the total detection rates of extensively drug-resistant A. baumannii and P. aeruginosa were 34.38% (493/1434) and 7.45% (140/1879), respectively.Conclusions Prevalence of CR K. pneumoniae has increased significantly in recent years. Resistance rates of A. baumannii to common antimicrobial agents have increased exponentially, reaching high levels. MRSA remains a challenge to control.


2019 ◽  
Vol 7 (2) ◽  
pp. 49-54
Author(s):  
Alka Hasani ◽  
Nasim Asadi Faezi ◽  
Mohammad Ahangarzadeh Rezaee ◽  
Elham Sheykhsaran ◽  
Narges Darabi ◽  
...  

Background: Bloodstream infections are considered a significant medical concern associated with high morbidity and mortality rates. Therefore, physicians should be guided to use antimicrobial susceptibility patterns in order to select appropriate empiric antimicrobial agents to treat the patients who suffer from bacteremia. Objective: The present study aimed to determine antimicrobial resistance and susceptibility patterns in isolates collected from bloodstream infections. Materials and Methods: To achieve this, a total of 710 bacterial blood culture isolates were collected from Sina hospital, and then susceptibility patterns to a number of antibiotics were analyzed according to Clinical and Laboratory Standards Institute guidelines. Results: The identified isolates included Staphylococcus aureus 14 (20.6%), Escherichia coli 14 (20.6%), Acinetobacter baumannii 12 (17.6%), Pseudomonas aeruginosa 11 (16.2%), Coagulasenegative Staphylococcus 8 (11.8%), Klebsiella pneumoniae 6 (8.8%), and Enterobacter spp. 3 (4.4%). The total resistance rate to co-trimoxazole, ceftriaxone, ceftazidime, cefotaxime, ofloxacin, gentamicin, ciprofloxacin, levofloxacin, amikacin, and imipenem was 44 (64.7%), 42 (61.8%), 39 (57.4%), 38 (55.9%), 35 (51.51%), 32 (47.1%), 31 (45.6%), 25 (36.8%), and 27 (39.7%), respectively. Finally, the susceptibility rate to amikacin and imipenem was 43 (63.2%) and 41 (60.3%), respectively. Conclusion: In general, A. baumannii strains isolated from blood cultures were resistant to most antibiotics and the greatest sensitivity was observed to gentamicin (58.3%) compared to other antibiotics. Therefore, gentamicin was found as the most effective antibiotic for treating bloodstream infections caused by A. baumannii.


Author(s):  
Nor Fadhilah Kamaruzzaman ◽  
Shamsaldeen Saeed

Abstract:Salmonella species (spp) and Escherichia coli (E. coli) are the most common infectious pathogens in poultry. Antimicrobials were given either for the treatment or growth promoters that can increase the possibility of emergence of bacterial resistance towards antimicrobials. The aim of this study was to determine the prevalence of antimicrobial resistant (AMR) Salmonella spp and E. coli isolated from a sample of broiler farms in East Coast Malaysia from 2018-2019. A total of 384 cloacal swabs were collected from broilers farms in Kelantan, Terengganu, and Pahang. The bacteria were isolated and confirmed by bacteriological and serological methods. Following that, confirmed isolates were subjected to antimicrobial susceptibility test. Salmonella spp and E. coli were recovered from the cloacal swabs samples with the overall prevalence of 6.5% and 51.8% respectively. In Kelantan, Terengganu and Pahang, the prevalence of Salmonella spp were 7%, 6.5% and 5.8% respectively, while the prevalence for E. coli were 50%, 48.3% and 58% respectively. Salmonella spp and E. coli displayed resistance towards the following antimicrobials: erythromycin (100% for both pathogens), chloramphenicol (76.2%, 84.5%), tetracycline (62%, 94.6%), ampicillin (47.7%, 87%), sulfamethoxazole/trimethoprim (42.9%, 83.3%), ciprofloxacin (4.8%, 23.8%), nalidixic acid (9.6%, 60.7%), streptomycin (19%,66%), and kanamycin (28.6%,57%), cephalotin (0%, 11%), gentamicin (0%, 20.2%) respectively. No resistance were recorded towards colistin for both pathogens. Multidrug resistance (MDR) was recorded in 82% of Salmonella spp and 100% of E. coli. These findings demonstrate the high prevalence of MDR Salmonella spp. and E. coli in broiler farms in East coast Malaysia. This could be attributed to the excessive use of antimicrobial agents by the poultry farm owners. Enhanced control measures and a strong monitoring system should be urgently implemented to reduce the emergence of antimicrobial resistance that is harmful to public health.


2020 ◽  
Vol 44 ◽  
Author(s):  
Jan M Bell ◽  
Thomas Gottlieb ◽  
Denise A Daley ◽  
Geoffrey W Coombs

The Australian Group on Antimicrobial Resistance (AGAR) performs regular period-prevalence studies to monitor changes in antimicrobial resistance in selected enteric gram-negative pathogens. The 2018 survey was the sixth year to focus on bloodstream infections, and included Enterobacterales, Pseudomonas aeruginosa and Acinetobacter species. Eight thousand three hundred and fifty isolates, comprising Enterobacterales (7,512, 90.0%), P. aeruginosa (743, 8.9%) and Acinetobacter species (95, 1.1%), were tested using commercial automated methods. The results were analysed using Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints (January 2019). Of the key resistances, resistance to the third-generation cephalosporin, ceftriaxone, was found in 13.4%/13.4% of Escherichia coli (CLSI/EUCAST criteria), and 9.4%/9.4% of Klebsiella pneumoniae. Resistance rates to ciprofloxacin were 15.2%/15.2% for E. coli, 11.3%/11.3% for K. pneumoniae, 7.4%/7.4% for Enterobacter cloacae complex, and 3.6%/7.7% for P. aeruginosa. Resistance rates to piperacillin-tazobactam were 3.0%/6.0%, 4.3%/7.9%, 18.2%/22.0%, and 5.1%/11.1% for the same five species respectively. Thirty-one isolates from 27 patients were shown to harbour a carbapenemase gene: 14 blaIMP-4 (11 patients), including one with blaIMP-4+blaOXA-23, four blaKPC (three patients), three blaOXA-48, three blaNDM, three blaGES. two blaOXA-181, and two blaOXA-23.


Author(s):  
Katarzyna Ćwiek ◽  
Anna Woźniak-Biel ◽  
Magdalena Karwańska ◽  
Magdalena Siedlecka ◽  
Christine Lammens ◽  
...  

Abstract Background A plasmid-mediated mechanism of bacterial resistance to polymyxin is a serious threat to public health worldwide. The present study aimed to determine the occurrence of plasmid-mediated colistin resistance genes and to conduct the molecular characterization of mcr-positive Escherichia coli strains isolated from Polish poultry. Methods In this study, 318 E. coli strains were characterized by the prevalence of mcr1–mcr5 genes, antimicrobial susceptibility testing by minimal inhibitory concentration method, the presence of antimicrobial resistance genes was screened by PCR, and the biofilm formation ability was tested using the crystal violet staining method. Genetic relatedness of mcr-1-positive E. coli strains was evaluated by multilocus sequence typing method. Results Among the 318 E. coli isolates, 17 (5.35%) harbored the mcr-1 gene. High antimicrobial resistance rates were observed for ampicillin (100%), tetracycline (88.24%), and chloramphenicol (82.35%). All mcr-1-positive E. coli strains were multidrug-resistant, and as many as 88.24% of the isolates contained the blaTEM gene, tetracycline (tetA and tetB), and sulfonamide (sul1, sul2, and sul3) resistance genes. Additionally, 41.18% of multidrug-resistant, mcr-1-positive E. coli isolates were moderate biofilm producers, while the rest of the strains showed weak biofilm production. Nine different sequence types were identified, and the dominant ST was ST93 (29.41%), followed by ST117 (17.65%), ST156 (11.76%), ST 8979 (11.76%), ST744 (5.88%), and ST10 (5.88%). Moreover, the new ST was identified in this study. Conclusions Our results showed a low occurrence of mcr-1-positive E. coli strains isolated from Polish poultry; however, all the isolated strains were resistant to multiple antimicrobial agents and were able to form biofilms at low or medium level.


2022 ◽  
Vol 8 ◽  
Author(s):  
Shuzhen Xiao ◽  
Chenyue Tang ◽  
Qian Zeng ◽  
Yilun Xue ◽  
Qing Chen ◽  
...  

Background: Bloodstream infections are recognized as important nosocomial infections. Escherichia coli (E. coli) is the most prevalent Gram-negative bacillary pathogen causing bloodstream infections (BSIs). This retrospective study investigated drug susceptibility and molecular epidemiology of E. coli isolated from patients with BSI in Shanghai, China.Methods: We collected E. coli isolated from the blood cultures of patients with BSI between January 2016 and December 2019. We randomly selected 20 strains each year to investigate antimicrobial resistance, resistance genes, and molecular epidemiological characteristics. Antimicrobial susceptibility testing was performed by the disk diffusion method. PCR was performed to detect extended-spectrum β-lactamases (ESBLs), carbapenemase genes, and housekeeping genes, and phyloviz was applied to analyze multilocus sequence typing (MLST).Results: Penicillins, first- and second-generation cephalosporins and fluoroquinolones have high resistance rates (>60%). Among the 80 randomly selected strains, 47 (58.8%) produced ESBLs, and one produced carbapenemase. Sequencing of resistance genes identified blaCTX−M−14 (34%, 16/47), blaCTX−M−15 (23.4%, 11/47) and blaCTX−M−27 (14.8%, 7/47) as the most prevalent genotypes of ESBLs. ST131 (14/80) was the most prevalent sequence type (ST), followed by ST1193 (10/80), ST648 (7/80).Conclusions: Our findings suggest that amikacin, carbapenems, and piperacillin-tazobactam have relatively low resistance rates and may be the preferred antibiotic regimens for empiric therapy. ST131 and blaCTX−M−14 are still the main prevalent in Shanghai with a rapid increase in the occurrence of ST1193 is rapidly increasing and more diverse blaCTX genes.


2019 ◽  
Vol 82 (10) ◽  
pp. 1667-1676 ◽  
Author(s):  
AMIT VIKRAM ◽  
ERIC MILLER ◽  
TERRANCE M. ARTHUR ◽  
JOSEPH M. BOSILEVAC ◽  
TOMMY L. WHEELER ◽  
...  

ABSTRACT Pork products from animals “raised without antibiotics” (RWA) are assumed to harbor lower levels of antimicrobial resistance (AMR) than conventional (CONV) pork products with no claims regarding use of antimicrobial agents during production. A total of 372 pork chop samples from CONV (n = 190) and RWA (n = 182) production systems were collected over 13 months from three food service suppliers. The following bacteria were cultured: Escherichia coli, tetracycline-resistant (TETr) E. coli, third-generation cephalosporin-resistant (3GCr) E. coli, Salmonella enterica, TETr Salmonella, 3GCr Salmonella, nalidixic acid–resistant Salmonella, Enterococcus spp., TETr Enterococcus, erythromycin-resistant Enterococcus, Staphylococcus aureus, and methicillin-resistant S. aureus. Production system did not significantly impact the detection of cultured bacteria (P > 0.05). Metagenomic DNA was isolated from each sample, and equal amounts of metagenomic DNA were pooled by supplier, month, and production system for 75 pooled samples (38 CONV, 37 RWA). Quantitative PCR was used to assess the abundances of the following 10 AMR genes: aac(6′)-Ie-aph(2″)-Ia, aadA1, blaCMY-2, blaCTX-M, blaKPC-2, erm(B), mecA, tet(A), tet(B), and tet(M). For all 10 AMR genes, abundances did not differ significantly (P > 0.05) between production systems. These results suggest that use of antimicrobial agents during swine production minimally impacts the AMR of bacteria in pork chops.


2020 ◽  
Vol 44 ◽  
Author(s):  
Jan M Bell ◽  
Alicia Fajardo Lubian ◽  
Sally Partridge ◽  
Thomas Gottlieb ◽  
Jonathan Iredell ◽  
...  

The Australian Group on Antimicrobial Resistance (AGAR) performs regular period-prevalence studies to monitor changes in antimicrobial resistance in selected enteric gram-negative pathogens. The 2019 survey was the seventh year to focus on bloodstream infections, and included Enterobacterales, Pseudomonas aeruginosa and Acinetobacter species. Eight thousand eight hundred and fifty-seven isolates, comprising Enterobacterales (7,983; 90.1%), P. aeruginosa (764; 8.6%) and Acinetobacter species (110; 1.2%), were tested using commercial automated methods. The results were analysed using Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints (January 2020). Of the key resistances, resistance to the third-generation cephalosporin ceftriaxone was found in 13.3%/13.3% (CLSI/EUCAST criteria) of Escherichia coli and 8.4%/8.4% of Klebsiella pneumonia. Resistance rates to ciprofloxacin were 16.0%/16.0% for E. coli, 10.2%/10.2% for K. pneumonia complex, 5.9%/5.9% for Enterobacter cloacae complex, and 4.1%/9.3% for P. aeruginosa. Resistance rates to piperacillin-tazobactam were 3.2%/5.7%, 4.7%/8.5%, 14.8%/21.4%, and 6.9%/12.5% for the same four species/complex respectively. Twenty-nine isolates from 29 patients were shown to harbour a carbapenemase gene: 15 blaIMP-4, five blaOXA-181, four blaOXA-23 (one with blaOXA-58 also), three blaNDM-4/5, one blaGES-5, and one blaIMP-1


2021 ◽  
Vol 7 (5) ◽  
pp. 1736-1745
Author(s):  
Jing Ping ◽  
Naiwei Li ◽  
Le Huang ◽  
Zhaohua Zhou ◽  
Xihong Zhang ◽  
...  

We aimed to explore the distribution of common pathogens and bacterial resistance in our hospital from 2017 to 2020, and to standardize clinical medication guidance. The pathogens isolated from the submitted specimens were identified, and drug susceptibility results were interpreted according to the Clinical and Laboratory Standards Institute guidelines (2017-2020). A total of 43,588 specimens were collected from patients treatedfrom 2017 to 2020, and 6,285 strains of pathogens were isolated. The most common pathogens were Escherichia coli, Haemophilus influenzae and Klebsiella pneumoniae.Methicillin-resistant Staphylococcus aureus (MRSA) accounted for 32.85%, and methicillin-resistant coagulase-negative Staphylococcus (MRCNS) accounted for 78.79%. The resistance rates of MRSA and MRCNS to ciprofloxacin, levofloxacin, erythromycin, clindamycin and trimethoprim-sulfamethoxazole were significantly higher than those of methicillin-sensitive S. aureus and methicillin-sensitive coagulase-negative Staphylococcus. The resistance rate of Streptococcus pneumoniae to erythromycin, tetracycline and clindamycin was higher than 80%. The detection rates of E. coli and K. pneumoniae producing ESBL strains were 62.2% and 25.6%, respectively. Totally, 769 carbapenem-resistant strains were detected, of which carbapenem-resistant Acinetobacter baumannii (CRAB) accounted for 66.6%, followed by carbapenem-resistant K. pneumoniae (CRKP) and carbapenem-resistant Pseudomonas aeruginosa (CRPA). A total of 202 CRE strains were detected, which were mainly isolated from respiratory tract and urine specimens. CRAB, CRKP and CRPA had higher resistance rates to antibacterial drugs. Gram-negative bacilli are the most common pathogens from 2017 to 2020. Considering that pathogens have high drug resistance, it is recommended to strengthen clinical management and rational application of antibiotics, thus reducing the risk of nosocomial infections.


2016 ◽  
Vol 79 (7) ◽  
pp. 1240-1246 ◽  
Author(s):  
RENATE BOSS ◽  
GUDRUN OVERESCH ◽  
ANDREAS BAUMGARTNER

ABSTRACT A total of 44 samples of salmon, pangasius (shark catfish), shrimps, and oysters were tested for the presence of Escherichia coli, enterococci, Pseudomonas aeruginosa, and Staphylococcus aureus, which are indicator organisms commonly used in programs to monitor antibiotic resistance. The isolated bacterial strains, confirmed by matrix-assisted laser desorption ionization time-of-flight mass spectroscopy, were tested against a panel of 29 antimicrobial agents to obtain MICs. Across the four sample types, Enterococcus faecalis (59%) was most common, followed by E. coli (55%), P. aeruginosa (27%), and S. aureus (9%). All bacterial species were resistant to some antibiotics. The highest rates of resistance were in E. faecalis to tetracycline (16%), in E. coli to ciprofloxacin (22%), and in S. aureus to penicillin (56%). Antibiotic resistance was found among all sample types, but salmon and oysters were less burdened than were shrimps and pangasius. Multidrug-resistant (MDR) strains were exclusively found in shrimps and pangasius: 17% of pangasius samples (MDR E. coli and S. aureus) and 64% of shrimps (MDR E. coli, E. faecalis, and S. aureus). Two of these MDR E. coli isolates from shrimps (one from an organic sample) were resistant to seven antimicrobial agents. Based on these findings, E. coli in pangasius, shrimps, and oysters, E. faecalis in pangasius, shrimps, and salmon, and P. aeruginosa in pangasius and shrimps are potential candidates for programs monitoring antimicrobial resistance. Enrichment methods for the detection of MDR bacteria of special public health concern, such as methicillin-resistant S. aureus and E. coli producing extended-spectrum β-lactamases and carbapenemases, should be implemented.


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