In Vitro Activity of Imipenem/Relebactam Against Enterobacteriaceae Isolates Obtained from Intra-abdominal, Respiratory Tract, and Urinary Tract Infections in China: Study for Monitoring Antimicrobial Resistance Trends (SMART), 2015–2018. (23rd December 2020)

• Record Type: Journal Article
• Authors: Yang, Qiwen; Zhang, Hui; Yu, Yunsong; Kong, Haishen; Duan, Qiong; Wang, Yong; Zhang, Shufang; Sun, Ziyong; Liao, Kang; Gu, Li; Jiang, Xiaofeng; Wu, Anhua; Huang, Wenxiang; Shan, Bin; Kang, Mei; Hu, Fupin; Yu, Hua; Zhang, Weijuan; Xu, Yingchun
• Is Part Of: Clinical infectious diseases. Volume 71(2020)Supplement 4
• Page Start: S427
• Page End: S435
• Publication Date: 2020-12-23
• Subjects: Enterobacteriaceae -- imipenem/relebactam -- SMART -- carbapenem -- imipenem-nonsusceptible; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciaa1519
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: Considering the increasing incidence of carbapenem-resistant Enterobacteriaceae in China, this study aimed to establish the in vitro effectiveness of imipenem/relebactam (IMI/REL) on clinical Enterobacteriaceae isolates derived from intra-abdominal infections (IAIs), respiratory tract infections (RTIs), and urinary tract infections (UTIs) in China between 2015 and 2018. Methods: In total, 8781 Enterobacteriaceae isolates from IAI, RTI, and UTI samples were collected from 22 hospitals across 7 geographic regions of China. Susceptibility to antimicrobial drugs was tested using the Clinical and Laboratory Standards Institute broth microdilution and breakpoints, and IMI/REL activity was assessed using United States Food and Drug Administration guidelines. Results: In 2015–2018, the most frequently identified Enterobacteriaceae species was Escherichia coli (n = 4676 [53.3%]), followed by Klebsiella pneumoniae (n = 2949 [33.6%]) and Enterobacter cloacae (n = 542 [6.2%]). The Enterobacteriaceae isolates showed 95.2% overall susceptibility to IMI/REL, of which the susceptibility rates in isolates from IAI, RTI, and UTI were 95.8%, 91.4%, and 96.6%, respectively. Overall, the susceptibilities of both intensive care unit (ICU) and non-ICU Enterobacteriaceae isolates to colistin were 92.9%, followed by IMI/REL (90.7% [95.9%]) and amikacin (83.3% [92.3%]). In addition, IMI/REL restored 66.3% susceptibility in imipenem-nonsusceptible Enterobacteriaceae. Conclusions: Given their high in vitro susceptibility, Enterobacteriaceae infections in China should be considered for IMI/REL treatment, especially with isolates that are not susceptible to carbapenems.