Investigation analysis of drug-resistant phenotypes of Escherichia coli clinically isolated from our hospital in 2016
JIANG Su-xiang1 ZHENG Gang-sen2 LIAN Ming-jian2 CHEN Mei-jun1▲
1.Department of Laboratory, Zhongshan Hospital Affiliated to Xiamen University, Fujian Province, Xiamen 361004,China;
2.Department of Laboratory, the First Affiliated Hospital of Xiamen University, Fujian Province, Xiamen,361003, China
Abstract：Objective To analyze the distribution of drug-resistance phenotypes of clinically isolated Escherichia coli,and to provide clinicians with laboratory data to better guide antibiotic therapy.Methods The clinical isolates of 851 Escherichia coli in the First Affiliated Hospital of Xiamen University from January to December 2016 were retrospectively analyzed.Strain identification and drug sensitivity test were conducted by BioMerieux VITEK2 Compact automatic bacterial identification and drug sensitivity analysis system.Results A total of 851 strains of Escherichia coli were clinically isolated in 2016, mainly including 425 (49.9%) strains from urine, 157 (18.4%) strains from whole blood,132 (15.5%) sterile strains from body fluid (including bile, ascites, pleural effusion, joint fluid but not cerebrospinal fluid), and 50 (5.9%) strains from sputum.There were four drug-resistant phenotypes of Tetracycline antibiotics (Tetracycline and Tegacycline), among which Tetracycline (R/I) Tegacycline (S) was the dominant phenotype.There were four drug-resistant phenotypes of Quinolone antibiotics(Ciprofloxacin and Levofloxacin) and two major phenotypes were Ciprofloxacin (R/I) Levofloxacin (R/I) and Ciprofloxacin (S) Levofloxacin (S).There were six drug-resistant phenotypes of aminoglycoside antibiotics (Gentamycin,Tobramycin and Amikacin) and two major phenotypes were Gentamycin (S) Tobramycin (S) Amikacin (S) and Gentamycin (R/I) Tobramycin (R/I) Amikacin (S).There were five drug-resistant phenotypes of β-lactam enzyme inhibitor complexes (Amoxicillin/Clavulanic Acid, Ampicillin/Sulbactam and Piperacillin/Tazobatam) and Amoxicillin/Clavulanic Acid (S) Ampicillin/Sulbactam (R/I) Piperacillin/Tazobattan (S) was the dominant phenotype.There were eleven drugresistant phenotypes of β-lactam antibiotics (Ampicillin, Cefuroxime, Ceftaxime, Ceftadime, Cefepime, Aztreonam,Imipenem and Meropenem) and two major phenotypes were Ampicillin (R/I) Cefuroxime (S) Ceftaxime (S) Ceftadime (S)Cefepime (S) Aztreonam (S) Imipenem (S) Meropenem (S) and Ampicillin (R/I) Cefuroxime (R/I) Ceftaxime (R/I) Ceftadime (S) Cefepime (S) Aztreonam (S) Imipenem (S) Meropenem (S).There were some differences in the distribution of drug-resistant phenotypes among different specimens, but the distribution of major drug-resistant phenotypes was basically consistent.The resistance rate of Escherichia coli to Tetracycline, Quinolones and aminoglycosamines was more than or close to 50%, but Escherichia coli remained highly sensitive to Tegacycline, Imipenem and Meropenem.Conclusion Escherichia coli mainly causes urinary tract infection, blood stream infection, cholecystitis and abdominal infection.The clinical prevalence of bacterial resistance phenotypes is relatively stable and the main kind of resistant pattern is relatively obvious.There are some differences in the distribution of drug-resistant phenotypes among different specimens.Depending on the source of the specimen, the clinicians can select appropriate antibiotics for relevant treatment, which can provide more specific theoretical basis for clinical experience in drug selection.
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