Patterns of Drug-Resistant Bacteria in a General Hospital, China, 2011–2016

Antimicrobial agent	MIC breakpoints	2011	2012	2013	2014	2015	2016	Total	χ²	p
Antimicrobial agent	I (μg/ml)	n = 276	n = 524	n = 486	n = 605	n = 781	n = 739	n = 3411	χ²	p
Ampicillin	16	97.1	99.05	98.97	99.5	100	100	99.38	5.2285	< 0.0001
Cefotaxime	2	52.17	54.39	45.27	56.86	100	100	73.67	26.9374	< 0.0001
Nitrofurantoin	64	76.81	65.84	49.59	56.36	54.16	58.59	58.49	−4.711	< 0.0001
Trimethoprim-sulfamethoxazole	4/76	71.38	70.61	52.06	35.7	37	55.07	50.78	−9.1411	< 0.0001
Ampicillin-sulbactam	16/8	52.54	49.81	46.09	40.17	47.25	47.9	46.79	−1.1923	0.2332
Cefuroxime	16	50.72	49.81	43.21	42.64	47.76	51.01	47.46	0.51	0.6101
Ceftriaxone	2	48.91	53.24	43.21	37.52	46.09	48.71	46.06	−0.9744	0.3299
Gentamicin	8	44.93	43.7	33.74	31.74	40.46	40.46	38.82	−0.8754	0.3813
Cefoxitin	16	40.58	43.51	34.77	31.9	39.44	39.51	38.17	−0.6514	0.5148
Levofloxacin	4	34.42	33.21	22.02	26.12	37.26	35.05	31.78	2.3291	0.0199
Cefepime	16	23.91	33.59	22.84	26.28	35.47	34.91	30.69	3.7816	0.0002
Piperacillin-tazobactam	32/4–64/4	21.74	24.81	18.93	23.64	32.01	30.58	26.41	4.7683	< 0.0001
Amikacin	32	26.09	26.53	16.05	18.02	28.55	23	23.19	0.376	0.7069
Meropenem	2	0	0	0	0.99	10.12	11.37	4.95	12.3843	< 0.0001
Imipenem	2	0	0	0	1.49	9.22	7.98	4.1	10.4364	< 0.0001

Distribution of bacterial isolates in relation to years and type of samples.

Category	No. isolates	Klebsiella pneumoniae		Escherichia coli		Staphylococcus aureus		Pseudomonas aeruginosa		Acinetobacter baumannii		Total
Category	No. isolates	n	%	n	%	n	%	n	%	n	%	n	%
Year
2011	1429	276	19.31	213	14.91	96	6.72	108	7.56	68	4.76	761	53.25
2012	3350	524	15.64	531	15.85	248	7.40	236	7.04	114	3.40	1653	49.34
2013	3143	486	15.46	493	15.89	219	6.98	168	5.35	114	3.63	1480	47.09
2014	3073	605	19.69	477	15.52	213	6.93	248	8.07	224	7.29	1767	57.50
2015	3750	781	20.83	522	13.92	254	6.77	259	6.91	292	7.89	2108	56.21
2016	4515	739	16.37	548	12.18	400	8.86	259	5.74	296	6.56	2242	49.66
Total	19260	3411	17.71	2784	14.45	1430	7.42	1278	6.64	1108	5.75	10011	51.98
χ²			1.5767		−4.7904		2.5513		−1.7311		7.8954		1.9893
p			0.1149		< 0.0001		0.0107		0.0834		< 0.0001		0.0467
Samples
Sputum		2741	80.36	493	17.71	81	5.66	1023	80.05	910	82.13	5248	27.25
Urine		382	11.2	1565	56.21	249	17.41	110	8.61	87	7.85	2393	12.42
Blood		104	3.05	265	9.52	275	19.23	30	2.35	24	2.17	698	3.62
Secretion		92	2.7	217	7.79	620	43.36	65	5.09	41	3.70	1035	5.37
Throat swabs		27	0.79	8	0.29	6	0.42	3	0.23	3	0.27	47	0.24
Others		65	1.91	236	8.48	199	13.92	47	3.68	43	3.88	590	3.06

The resistance rates of S. aureus to 18 antimicrobial agents in the years 2011 to 2016.

Antimicrobial agent	MIC breakpoints	2011	2012	2013	2014	2015	2016	Total	χ²	p
Antimicrobial agent	I (\|ig/ml)	n = 96	n = 248	n = 219	n = 213	n = 254	n = 400	n = 1430	χ²	p
Penicillin	0.25	92.71	93.55	94.06	95.77	88.19	89.00	91.68	−2.759	0.0058
Erythromycin	1–4	95.83	87.10	80.82	80.28	82.28	81.00	83.15	−3.0012	0.0027
Azithromycin	4	90.63	86.29	80.37	81.22	77.95	76.50	80.70	−3.8879	0.0001
Clarithromycin	4	90.63	83.87	79.45	79.81	70.08	69.00	76.43	−6.0151	< 0.0001
Trimethoprim-sulfamethoxazole	4/76	85.42	91.13	62.56	69.95	73.62	51.25	68.95	−9.9209	< 0.0001
Clindamycin	1-2	67.71	65.73	59.36	56.34	55.12	58.25	59.51	−2.4495	0.0143
Cefoxitin	8	69.79	72.18	71.23	58.69	44.49	41.50	56.36	−9.6125	< 0.0001
Norfloxacin	8	70.83	64.11	63.01	59.62	52.36	43.75	55.94	−6.6063	< 0.0001
Levofloxacin	2	67.71	61.29	57.99	56.34	48.43	36.25	51.19	−7.6331	< 0.0001
Moxifloxacin	1	63.54	56.45	52.51	53.99	48.03	34.50	48.32	−6.5328	< 0.0001
Gentamicin	8	64.58	64.11	46.12	45.54	35.83	35.00	45.45	−8.242	< 0.0001
Tetracycline	8	58.33	57.26	47.49	47.42	38.98	37.00	45.45	−5.9025	< 0.0001
Oxacillin	4	53.13	42.74	33.79	43.66	45.67	42.25	42.59	−0.6128	0.8283
Rifampicin	2	40.63	30.65	25.57	21.60	17.32	10.00	21.19	−8.1147	< 0.0001
Nitrofurantoin	64	26.04	15.73	16.44	9.86	5.91	8.00	11.75	−5.7483	< 0.0001
Teicoplanin	16	11.46	12.10	5.02	4.23	0.79	1.75	4.90	−6.6928	< 0.0001
Linezolid	8	0	0	0	0	0	0	0
Vancomycin	4–8	0	0	0	0	0	0	0

The resistance rates of P. aeruginosa to 13 antimicrobial agents in the years 2011 to 2016.

Antimicrobial agent	MIC breakpoints	2011	2012	2013	2014	2015	2016	Total	χ²	p
Antimicrobial agent	I (μg/ml)	n = 108	n = 236	n = 168	n = 248	n = 259	n = 259	n = 1278	χ²	p
Ticarcillin	32-64	70.37	74.58	76.79	76.21	75.29	76.45	75.35	0.9182	0.3585
Piperacillin	32-64	57.41	63.14	54.76	56.45	61.00	61.39	59.47	0.3942	0.6934
Imipenem	4	50.00	52.97	60.71	53.63	62.16	57.92	56.73	1.8507	0.0642
Aztreonam	16	50.93	48.31	54.76	50.00	52.90	54.83	51.96	1.1464	0.2516
Gentamicin	8	52.78	61.02	55.36	43.95	49.42	50.58	51.80	−2.2516	0.0243
Ceftazidime	16	43.52	52.54	54.76	49.19	51.74	53.28	51.41	0.8686	0.3851
Tobramycin	8	53.70	58.90	52.38	39.11	49.81	44.40	48.98	−3.0892	0.0020
Piperacillin-tazobactam	32/4–64/4	43.52	51.27	42.86	41.94	52.90	53.28	48.44	1.6789	0.0932
Norfloxacin	8	50.93	54.24	47.02	39.92	48.26	48.26	47.81	−1.2309	0.2183
Meropenem	4	44.44	41.95	45.24	45.16	54.44	49.81	47.34	2.4052	0.0162
Cefepime	16	42.59	46.19	50.60	37.90	49.81	51.74	46.71	1.5010	0.1334
Ciprofloxacin	2	48.15	52.97	45.83	41.53	45.56	44.02	46.09	−1.7609	0.0783
Levofloxacin	4	45.37	47.88	40.48	37.90	45.95	45.95	43.97	−0.0615	0.9510
Amikacin	32	36.11	40.68	37.50	29.03	35.52	36.29	35.68	−0.9114	0.3621
Polymyxin B	4	20.37	19.49	14.29	9.68	13.51	6.56	13.15	−4.5199	< 0.0001

The resistance rates of A. baumannii to 13 antimicrobial agents in the years 2011 to 2016.

Antimicrobial agent	MIC breakpoints	2011	2012	2013	2014	2015	2016	Total	χ²	p
Antimicrobial agent	I (μg/ml)	n = 68	n = 114	n = 114	n = 224	n = 292	n = 296	n = 1108	χ²	p
Ceftriaxone	16–32	32.35	64.04	72.81	72.77	79.11	80.74	73.19	7.4412	< 0.0001
Ampicillin-sulbactam	16/8	41.18	64.91	81.58	76.79	73.63	64.53	69.77	1.5591	0.1190
Gentamicin	8	44.12	67.54	64.04	74.55	68.15	75.68	69.49	4.0867	< 0.0001
Ciprofloxacin	2	39.71	57.89	64.04	73.66	69.52	75.34	68.32	5.6165	< 0.0001
Ceftazidime	16	39.71	52.63	64.04	66.07	62.67	72.64	63.72	5.0871	< 0.0001
Trimethoprim-sulfamethoxazole	4/76	39.71	63.16	60.53	60.27	66.78	64.86	62.27	3.0414	0.0024
Cefepime	16	35.29	50.00	56.14	62.05	61.99	70.95	60.92	5.8829	< 0.0001
Levofloxacin	4	41.18	53.51	64.04	65.18	59.93	64.53	60.83	2.9341	0.0033
Piperacillin-tazobactam	32/4–64/4	29.41	50.00	57.02	58.04	64.38	68.24	59.75	6.0938	< 0.0001
Amikacin	32	33.82	60.53	56.14	62.50	57.53	62.84	58.66	2.8410	0.0045
Meropenem	4	19.12	46.49	57.89	54.02	47.95	47.64	48.19	1.9045	0.0568
Imipenem	4	20.59	48.25	61.40	59.38	45.55	37.16	46.48	−1.0354	0.3005
Polymyxin B	4	10.29	21.93	15.79	19.64	13.63	18.24	16.88	0.0504	0.9598

The resistance rates of E. coli to 16 antimicrobial agents in the years 2011 to 2016.

Antimicrobial agent	MIC breakpoints	2011	2012	2013	2014	2015	2016	Total	χ²	p
Antimicrobial agent	I (μg/ml)	n = 213	n = 531	n = 493	n = 477	n = 522	n = 548	n = 2784	χ²	p
Ampicillin	16	92.49	93.03	90.06	86.37	87.16	88.87	89.4	−3.0413	0.0024
Cefotaxime	2	69.01	72.88	71.4	73.17	100	100	82.79	16.5655	< 0.0001
Trimethoprim-sulfamethoxazole	4/76	93.9	93.03	81.74	77.99	70.69	69.16	79.63	−11.9199	< 0.0001
Ampicillin-sulbactam	16/8	76.06	73.63	80.53	67.92	60.15	62.96	69.43	−6.7117	< 0.0001
Cefuroxime	16	70.42	73.45	71.81	67.51	60.92	62.59	67.42	−4.8433	< 0.0001
Levofloxacin	4	73.71	71.56	67.95	65.62	66.67	61.13	67.1	−4.0714	< 0.0001
Ceftriaxone	2	69.01	72.5	68.97	64.36	60.15	62.23	65.88	−4.3853	< 0.0001
Gentamicin	8	74.18	65.73	60.45	59.75	51.34	52.92	59.2	−6.7725	< 0.0001
Cefepime	16	49.77	54.24	46.25	38.36	30.65	38.32	42.21	−7.1678	< 0.0001
Ceftazidime	8	17.84	1.32	48.48	43.61	34.29	36.31	31.25	9.9654	< 0.0001
Cefoxitin	16	30.52	29.57	29.41	21.17	12.07	10.77	21.19	−10.1704	< 0.0001
Nitrofurantoin	64	28.17	27.31	16.02	14.47	10.73	11.13	16.88	−8.6556	< 0.0001
Piperacillin-tazobactam	32/4-64/4	14.55	18.64	13.18	13.63	6.7	10.77	12.72	−4.6131	< 0.0001
Amikacin	32	18.31	15.25	10.75	8.39	8.24	8.03	10.78	−5.3067	< 0.0001
Imipenem	2	0.94	1.51	2.43	1.26	1.15	1.64	1.54	−0.1060	0.9156
Meropenem	2	0	0.56	0.2	1.05	0.96	2.01	0.9	3.1604	0.0016

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Patterns of Drug-Resistant Bacteria in a General Hospital, China, 2011–2016

Article Category: original-paper

Online veröffentlicht: 28. Juni 2019

Seitenbereich: 225 - 232

Eingereicht: 28. Nov. 2018

Akzeptiert: 06. März 2019

DOI: https://doi.org/10.33073/pjm-2019-024

Schlüsselwörterantimicrobial resistance, Gram-negative bacteria, ESBL, MRSA, surveillance

© 2019 Tingting Mao et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

The resistance rates of K. pneumoniae to 15 antimicrobial agents in the years 2011 to 2016.

Distribution of bacterial isolates in relation to years and type of samples.

The resistance rates of S. aureus to 18 antimicrobial agents in the years 2011 to 2016.

The resistance rates of P. aeruginosa to 13 antimicrobial agents in the years 2011 to 2016.

The resistance rates of A. baumannii to 13 antimicrobial agents in the years 2011 to 2016.

The resistance rates of E. coli to 16 antimicrobial agents in the years 2011 to 2016.

Schlüsselwörter
antimicrobial resistance, Gram-negative bacteria, ESBL, MRSA, surveillance