Infection and Drug Resistance (Aug 2023)
Comparison of Epidemiological Characteristics Between ESBL and Non-ESBL Isolates of Clinically Isolated Escherichia coli from 2014 to 2022: A Single-Center Study
Abstract
Wei Zhang,1,2,* Qing Wang,3,* Liru Zhang,4,* Jiangxiong Wu,5 Jinlu Liu,2 Cheng Lu,2 Xinsheng Wang,1 Zhihua Zhang6 1Central Laboratory, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, People’s Republic of China; 2Microbiology Laboratory, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, People’s Republic of China; 3Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Beijing, People’s Republic of China; 4Clinical Laboratory, Zhangjiakou Wanquan District Hospital, Zhangjiakou, Hebei, People’s Republic of China; 5Inspection Center, Qujing No.1 People’s Hospital, Affiliated Qujing Hospital of Kunming Medical University, Qujing, Yunnan, People’s Republic of China; 6Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhihua Zhang, Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, 36 Changqing Road, Qiaoxi District, Zhangjiakou City, Hebei Province, People’s Republic of China, Tel +86-03138043503, Fax +86-1088326317, Email [email protected] Xinsheng Wang, Central Laboratory, The First Affiliated Hospital of Hebei North University, Zhangjiakou, 36 Changqing Road, Qiaoxi District, Zhangjiakou City, Hebei Province, People’s Republic of China, Email [email protected]: 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. The data were analyzed using the software WHONET5.6 and the R language platform.Results: 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%), chloramphenicol (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 more 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.Keywords: antibiotic resistance, bacteria, ESBL, carbapenems, cephalosporin, quinolones
