Antimicrob Resist Infect Control 2019 29;8:61. Epub 2019 Mar 29.
1Department of Laboratory Medicine, the First Affiliated Hospital of Chongqing Medical University, No.1, Youyi Road, Yuzhong District, Chongqing, 400016 People's Republic of China.
Background: ESKAPEEc contribute to a majority of bloodstream infections (BSIs) and their antibiogram have changed overtime, while data concerning about these alterations are lacking in China. Added that a paucity of studies referred to ESKAPEEc in pediatric BSIs, our study aimed to demonstrate the longitudinal alterations of ESKAPEEc distribution and antibiogram in adult and pediatric BSIs in Southwest China.
Methods: A multicenter retrospective surveillance study was launched from 2012 to 2017. Data of China Antimicrobial Resistance Surveillance System (CARSS) was analyzed by Whonet 5.6 and Graphpad Prism 6 Software. test or exact test was used to examine and compare temporal changes.
Results: A total of 32,259 strains was isolated, with 17.4% from pediatric BSIs. ESKAPEEc contributed to 58.67% (18,924/32,259) of BSIs, with 65.3% of adult BSIs and 27.2% of pediatric BSIs. () and () were the two predominant species. Carbapenem resistance was prevalent in 0.76, 4.60, 9.47,13.66, 59.47% of , , , () and (), respectively. The proportions of methicillin-resistant (MRSA) and vancomycin-resistant (VREFM) were 28.91% and 2.20%, respectively. Between 2012-2014 and 2015-2017, and showed significantly increased resistance rates to imipenem but decreased to ceftriaxone and ceftazidime, while exhibited reduced resistances to almost all the beta-lactams tested. The prevalence of antimicrobial resistance to most of agents against Gram-positive ESKAPEEc did not significantly varied during the same timeframe. In comparison with those from adult BSIs, from pediatric BSIs exhibited high resistance rates to all the beta-lactams tested, especially to carbapenems (12.79% vs 3.87%), while showed low resistance rates to all the agents.
Conclusions: Ongoing burden of ESKAPEEc in BSIs and increasing trend of imipenem resistance in and call for continued surveillance. Carbapenems are still active against Gram-negative ESKAPEEc, except for and vancomycin or linezolid is still effective against Gram-positive ESKAPEEc. Carbapenem-resistant in children and carbapenem-resistant in adults necessitate effective antimicrobial strategies in consideration of age stratification.