Antimicrobial resistance and epidemiology of extended spectrum-β-lactamases (ESBL)-producing Escherichia coli and Enterobacter cloacae isolates from intensive care units at obstetrics & gynaecology departments: a retrospective analysis

Background: There are increasing concerns towards the transmission of extended spectrum-β-lactamases (ESBL)-producing Enterobacteriaceae in hospital intensive care units (ICUs) at obstetrics & gynaecology departments. The aim this study was to determine clinical characteristics and prevalence ESBL-producing Escherichia coli (E. coli) Enterobacter cloacae cloacae) isolates collected from ICUs departments a tertiary hospital, China. This also explored treatment options for E. infections. Methods: ICU samples were identified by using Vitek 2 Compact System with GN ASTGN13 cards. Antimicrobial susceptibility profiles determined broth microdilution method. Double-disk synergy test (DDST) performed screen ESBLs combined EDTA-disc detect production carbapenemase. Enterobacterial repetitive intergenic consensus (ERIC)-PCR applied investigate clonality isolates. Results: A total 223 strains isolated 283 hospitalized patients nosocomial infections between 2017 2019 analyzed. Of these, 104 classified as 103 VITEK GNI system. 207 isolates, 131 (63.3%) separated sputum or tracheal secretions. ESBL-screen positive 45.2% (47/104) coli, 44.7% (46/103) cloacae. Resistance rates 95.5% 91.3% ampicillin, respectively; 80.6% 76.1% ampicillin/tazobactam; 88.1% 28.3% ciprofloxacin; 89.6% 15.2% levofloxacin; 34.3% 45.7% netilmicin; 82.1% 41.3% compound sulfamethoxazole; 20.9% 43.5% amikacin; 58.2% 37.0% gentamicin; 69.6% piperacillin/tazobactam. Additionally, all fully resistant cefazolin, cefuroxime, ceftazidime, ceftriaxone, cefepime, aztreonam. On other hand, susceptible imipenem meropenem. Results ERIC-PCR exhibited 11 distinct patterns similarity coefficient 0.8. Only one ERIC pattern observed amongst 46 Analysis demonstrated that there an outbreak infection gynecology hospital. Discussion: Our data indicate circulating constitute major source spread. It is necessary increase surveillance develop adequate prevention strategies.