Background: Over the years, the emergence and spread of extended-spectrum β-lactamase (ESBL)-producing E. coli strains have become a significant concern in clinical settings. Understanding the epidemiological characteristics of ESBL-producing E. coli isolates is crucial for effective infection control and antibiotic stewardship.
Aim: This single-center study aims to investigate the
epidemiological characteristics of clinically isolated Escherichia coli from 2014 to 2022.
Methods: In vitro drug sensitivity of E. coli to 20 antibiotics was examined using the microbroth
dilution method. A total of 7580 clinical E.
coli strains were isolated from 2014 to 2022, among which 56.9% were
identified as extended-spectrum beta-lactamase-producing strains. Drug susceptibility
testing was performed using the broth microdilution method according to the
guidelines provided by the Clinical and Laboratory Standards Institute (CLSI).
The data were analyzed using the software WHONET5.6 and the R language
platform.
Results: The number of female patients exceeds that of males
(4798 vs.2782), and the median age of females is higher than that of males.
Over the study period, carbapenem resistance rates increased by more than 50%
(2022 [1.34%] vs 2014 [0.8%]) and the annual number of isolates showed an
upward trend (1264 in 2022 vs 501 in 2014). Drug resistance rates were the
highest for penicillin (75–85%) and lowest for imipenem (1%). The resistance
rate of strains isolated from male patients and sputum was found to be higher
than that of female patients and urine, except for quinolones (p <0.05). The
drug resistance rates from high to low were penicillins (75– 85%), tetracycline
(64%), quinolones (64–67%), sulfamethoxazole (59.3%), cephalosporins (22–72%),
aztreonam (34%), chloram-phenicol (21%), amikacin (2.8%), colistin (1.4%),
meropenem (1.1%), and imipenem (1%). Urine, sputum, and blood accounted for
51%, 16.6%, and 10.6% of the samples, respectively. A greater number of female
patients were included than male patients (4798[63.3%] vs 2782[26.7%]).
Patients aged 50–80 accounted for 64.2% of those surveyed.
Conclusion: Carbapenems remain the optimal choice for
treating extended-spectrum beta-lactamase-producing E. coli infections (sensitivity rate: 98%). Colistin (87.7%) and
amikacin (87%) exhibited good antibacterial activities against
carbapenem-resistant E. coli.
Long-term and continuous epidemiological surveillance of E. coli can facilitate the development of preventive strategies and
control policies. In future research, bacterial genotyping has made a great
contribution to the epidemiology of drug-resistant bacteria, and it should
gradually become the mainstream monitoring method to be implemented.
Author (s) Details
Wei Zhang
Central Laboratory, The First Affiliated Hospital of Hebei North
University, Zhangjiakou, Hebei, People’s Republic of China and Microbiology
Laboratory, The First Affiliated Hospital of Hebei North University,
Zhangjiakou, Hebei, People’s Republic of China.
Qing Wang
Clinical Laboratory, State Key Laboratory of Complex Severe and Rare
Diseases, Beijing, People’s Republic of China.
Liru Zhang
Clinical Laboratory, Zhangjiakou Wanquan District Hospital, Zhangjiakou,
Hebei, People’s Republic of China.
Jiangxiong Wu
Inspection Center, Qujing No.1 People’s Hospital, Affiliated Qujing
Hospital of Kunming Medical University, Qujing, Yunnan, People’s Republic of
China.
Jinlu Liu
Microbiology Laboratory, The First Affiliated Hospital of Hebei North
University, Zhangjiakou, Hebei, People’s Republic of China.
Cheng Lu
Microbiology Laboratory, The First Affiliated Hospital of Hebei North
University, Zhangjiakou, Hebei, People’s Republic of China.
Xinsheng Wang
Central Laboratory, The First Affiliated Hospital of Hebei North
University, Zhangjiakou, Hebei, People’s Republic of China.
Zhihua Zhang
Department of Respiratory and Critical Care Medicine, The First Affiliated
Hospital of Hebei North University, Zhangjiakou, Hebei, People’s Republic of
China.
Please see the book here:- https://doi.org/10.9734/bpi/acmms/v8/2286
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