Community-acquired Bloodstream Infections Caused By Extended Spectrum β-lactamase Producing Escherichia Coli And Klebsiella Pneumoniae:Epidemiology,Risk Factors And Treatment Analysis

Objective:To explore community-acquired Epidemiology, and risk factors of Community-acquired bloodstream infections caused by extended spectrum β-lactamase producing Escherichia coli and Klebsiella pneumoniae, which were isolated from Sir Run Run Shaw Hospital in Hangzhou. To invest igate the genotype distribution of extended-spectrum β-lactamases(ESBLs) produced by Escherichia coli and Klebsiella pneumoniae in Hangzhou, and to analyze the antimicrobial activity of clinically commonly used antibiotics.Methods:Amount of39paitents with community-acquired bloodstream infections caused by extended spectrum β-lactamase producing Escherichia coli and Klebsiella pneumoniae were collected from Sir Run Run Shaw Hospital. Extended spectrum β-lactamases(ESBLs) was identified by disc screening testing. Antimicrobial susceptibility of twelve clinically commonly used antibiotics were determined by agar dilution and broth microdilution method for ESBLs positive isolates. The genotypes of extended spectrum β-lactamases(ESBLs) were determined by polymerase chain reaction(PCR).SPSS20.0software was used to analyze the clinical data of54patients.Result:The postive rates of producing ESBLs of Escherichia coli and Klebsiella pneumoniae were51.3%and13.3%, respectively, which were isolated from patients of community-acquired bloodstream infections in Hangzhou.Age is the only risk factors associated with ESBL-producing strains identified by this research. Four isolates of twenty-two ESBLs postive strains produced only one genotype of ESBLs, other strains produced two or more genotypes of ESBLs,and CTX-M-14is the most common genotype.Different antibiotics for bloodstream infections caused by ESBLs producing strains have obvious different treatment outcomes. Carbapenems show a highest success rates, followed by complex preparations, and other antibiotics, including quinolones, third generation cephalosporins, have no success case.Conclusion:The prevalence of community-acquired bloodstream infections caused by ESBLs-producing Escherichia coli is increasingly serious.Carbapenem antibiotics have higher antimicrobial activitives, followed by enzyme inhibitor-containing β-lactam antibiotics, which is consistent with the clinical treatment outcomes.CTX-M-14is the most common genotype of ESBLs producing strains.Detecting the prevalence and drug resistance of ESBLs producing Escherichia coli and Klebsiella pneumoniae is very significant for clinical treatments.