Distribution characteristics and drug resistance of carbapenem-resistant Enterobacteriaceae in children from 2016 to 2017
Bingjie Wang, Fen Pan, Hong Zhang, Ting Zhang, Hongmei Xu, Chunmei Jing, Chuanqing Wang, Aimin Wang, Hui Yu, Shuzhen Han, Aiwei Lin, Shifu Wang, Qing Cao, Xing Wang, Chunzhen Hua, Yinghu Chen, Xuejun Chen, Jikui Deng, Ruizhen Zhao, Huiling Deng, Sancheng Cao, Jianhua Hao, Wei Gao, Yiping Chen, Jinhong Yang
Abstract
ObjectiveTo investigate the distribution and drug resistance of carbapenem-resistant Enterobacteriaceae (CRE) isolated from children in China.
MethodsCRE strains were collected in 10 tertiary children's hospitals of China from January 1, 2016 to December 31, 2017. Antimicrobial susceptibility of the clinical strains was detected with disk diffusion method (KB method) and automated method. The results were analyzed according to the Clinical and Laboratory Standards Institute (CLSI) Standards published in 2017. WHONET 5.6 software was used to retrospectively analyze the distribution characteristics and drug resistance of these strains.
ResultsA total of 3 065 CRE clinical strains were isolated from children with an overall prevalence of 7.7% and among them, 13.5% were isolated in neonatal group and 5.8% in non-neonatal group. The detection rate of CRE in 2017 was higher than that in 2016 (9.7% vs 5.7%). Among the 3 065 CRE strains, there were 1 912 strains of Klebsiella pneumoniae (62.0%), 667 strains of Escherichia coli (22.0%), 206 strains of Enterobacter cloacae (7.0%), 56 strains of Klebsiella aerogenes (1.8%) and 47 strains of Serratia marcescens (1.5%). Most of the strains were isolate in neonatology departments including neonatal intensive care units (NICU) and intensive care units (ICU), accounting for 44.8% and 19.7%, respectively. Respiratory tract (61.8%), urine (19.4%) and blood (5.7%) specimens were the main sources of CRE isolates. Results of antimicrobial susceptibility test showed that the CRE strains were highly resistant to carbapenem antibiotics such as imipenem, meropenem and ertapenem, as well as penicillins and most cephalosporins (79.6%-100%), especially those isolated in the neonatal group (P<0.05). Children had relatively low resistance rates to aminoglycosides such as amikacin (19.7%) and fosfomycin (11.9%), fluoroquinolones such as levofloxacin (37.7%) and ciprofloxacin (43.3%), and tigecycline (3.8%). Currently, no polymyxin B-resistant strains were isolated.
ConclusionsThe prevalence of common CRE strains in children in 2017 was higher than that in 2016, especially in newborns. Drug resistance in CRE strains isolated from neonates to common antibiotics was more severe, suggesting that great attention should be paid to it and timely measures should also be taken.
Key words:
Carbapenem-resistant Enterbacteriaceae; Drug resistance; Children
Contributor Information
Bingjie Wang
Department of Clinical Laboratory, Children′s Hospital of Shanghai, Children′s Hospital of Shanghai Jiaotong University, Shanghai 200040, China
Fen Pan
Department of Clinical Laboratory, Children′s Hospital of Shanghai, Children′s Hospital of Shanghai Jiaotong University, Shanghai 200040, China
Hong Zhang
Department of Clinical Laboratory, Children′s Hospital of Shanghai, Children′s Hospital of Shanghai Jiaotong University, Shanghai 200040, China
Ting Zhang
Department of Infectious Diseases, Children′s Hospital of Shanghai, Children′s Hospital of Shanghai Jiaotong University, Shanghai 200040, China
Hongmei Xu
Department of Infectious Diseases, Children′s Hospital of Chongqing Medical University, Chongqing 400014, China
Chunmei Jing
Department of Clinical Laboratory, Children′s Hospital of Chongqing Medical University, Chongqing 400014, China
Chuanqing Wang
Department of Microbiology Laboratory, Clinical Laboratory Center, Children′s Hospital of Fudan University, Shanghai 201102, China
Aimin Wang
Department of Microbiology Laboratory, Clinical Laboratory Center, Children′s Hospital of Fudan University, Shanghai 201102, China
Hui Yu
Department of Infectious Diseases, Children′s Hospital of Fudan University, Shanghai 201102, China
Shuzhen Han
Department of Infectious Diseases, Children′s Hospital of Fudan University, Shanghai 201102, China
Aiwei Lin
Department of Infectious Diseases, Qilu Children′s Hospital of Shandong University, Jinan 250022, China
Shifu Wang
Department of Clinical Laboratory, Qilu Children′s Hospital of Shandong University, Jinan 250022, China
Qing Cao
Department of Infectious Diseases, Shanghai Children′s Medical Center, Shanghai 200127, China
Xing Wang
Department of Clinical Laboratory, Shanghai Children′s Medical Center, Shanghai 200127, China
Chunzhen Hua
Department of Infectious Diseases, Zhejiang University School of Medicine, Hangzhou 310052, China
Yinghu Chen
Department of Infectious Diseases, Zhejiang University School of Medicine, Hangzhou 310052, China
Xuejun Chen
Department of Clinical Laboratory, Zhejiang University School of Medicine, Hangzhou 310052, China
Jikui Deng
Department of Infectious Diseases, Children′s Hospital of Shenzhen, Shenzhen 518038, China
Ruizhen Zhao
Department of Clinical Laboratory, Children′s Hospital of Shenzhen, Shenzhen 518038, China
Huiling Deng
Department of Infectious Diseases, the Children′s Hospital of XI′an City, Xi′an 710003, China
Sancheng Cao
Department of Clinical Laboratory, the Children′s Hospital of XI′an City, XI′an 710003, China
Jianhua Hao
Department of Infectious Diseases, Children′s Hospital of Kaifen City(Eastern Hospital), Kaifeng 475000, China
Wei Gao
Department of Clinical Laboratory, Children′s Hospital of Kaifen City(Eastern Hospital), Kaifeng 475000, China
Yiping Chen
Department of Infectious Diseases, Yuying Children′s Hospital of Wenzhou Medical University, Wenzhou 325027, China
Jinhong Yang
Department of Clinical Laboratory, Yuying Children′s Hospital of Wenzhou Medical University, Wenzhou 325027, China
