Shifts in hospital-associated pathogens and prevalence trends of carbapenem-resistant Escherichia coli infections, 2021–2023

Introduction: Carbapenem-resistant Escherichia coli (CREC) have emerged as a significant global health threat, particularly in hospital settings, due to their high resistance to critical antibiotics. This study aimed to evaluate the dynamics of pathogenic bacterial isolates in clinical specimens, c...

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Main Authors: Luyao Liu, Shihui Liu, Zhenghai Yang, Fan Wang, Huiwen Yuan, Hao Xu, Jinguan Chen, Xiaoning Li
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2025-07-01
Series:Journal of Infection in Developing Countries
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Online Access:https://www.jidc.org/index.php/journal/article/view/20930
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author Luyao Liu
Shihui Liu
Zhenghai Yang
Fan Wang
Huiwen Yuan
Hao Xu
Jinguan Chen
Xiaoning Li
author_facet Luyao Liu
Shihui Liu
Zhenghai Yang
Fan Wang
Huiwen Yuan
Hao Xu
Jinguan Chen
Xiaoning Li
author_sort Luyao Liu
collection DOAJ
description Introduction: Carbapenem-resistant Escherichia coli (CREC) have emerged as a significant global health threat, particularly in hospital settings, due to their high resistance to critical antibiotics. This study aimed to evaluate the dynamics of pathogenic bacterial isolates in clinical specimens, characterize patients with CREC infections, and identify risk factors for co-infection; in order to strengthen surveillance and infection control measures. Methodology: Clinical specimens were collected from patients at a tertiary hospital in southern Anhui Province between 2021 and 2023. Strain identification and antibiotic susceptibility testing were performed using a time-of-flight mass spectrometry analyzer and the VITEK-2 compact system. Demographic and clinical data were analyzed using rigorous statistical methods. Results: The predominant bacterial species isolated included Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii. Notably, the prevalence of CREC increased from 10.10% in 2021 to 16.36% in 2023. The predominant carbapenem-resistant Enterobacteriaceae (CRE) species were Enterobacter cloacae, Klebsiella pneumoniae, and Escherichia coli; with the proportion of CREC increasing significantly from 10.10% in 2021 to 16.36% in 2023. Of the 81 patients with CREC, 65.43% were over 60 years old. The most common specimen types were urine and sputum, with the highest proportion of patients in the intensive care unit (ICU; 32.10%). Analysis of the co-infected population revealed that ICU patients with tracheal intubation were significant risk factors. Co-infection with carbapenem-resistant Acinetobacter baumannii (CRAB) showed a concerning annual rise. Conclusions: There is urgent need for enhanced surveillance and stringent infection control measures to mitigate the spread of CREC and associated nosocomial infections.
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spelling doaj-art-dbb7b77eafec4ba482975ca20c6bee3d2025-08-02T00:22:32ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802025-07-01190710.3855/jidc.20930Shifts in hospital-associated pathogens and prevalence trends of carbapenem-resistant Escherichia coli infections, 2021–2023Luyao Liu0Shihui Liu1Zhenghai Yang2Fan Wang3Huiwen Yuan4Hao Xu5Jinguan Chen6Xiaoning Li7Department of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, ChinaDepartment of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, ChinaDepartment of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, ChinaDepartment of Dermatology, the First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, ChinaDepartment of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, ChinaDepartment of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, ChinaDepartment of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, ChinaDepartment of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China Introduction: Carbapenem-resistant Escherichia coli (CREC) have emerged as a significant global health threat, particularly in hospital settings, due to their high resistance to critical antibiotics. This study aimed to evaluate the dynamics of pathogenic bacterial isolates in clinical specimens, characterize patients with CREC infections, and identify risk factors for co-infection; in order to strengthen surveillance and infection control measures. Methodology: Clinical specimens were collected from patients at a tertiary hospital in southern Anhui Province between 2021 and 2023. Strain identification and antibiotic susceptibility testing were performed using a time-of-flight mass spectrometry analyzer and the VITEK-2 compact system. Demographic and clinical data were analyzed using rigorous statistical methods. Results: The predominant bacterial species isolated included Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii. Notably, the prevalence of CREC increased from 10.10% in 2021 to 16.36% in 2023. The predominant carbapenem-resistant Enterobacteriaceae (CRE) species were Enterobacter cloacae, Klebsiella pneumoniae, and Escherichia coli; with the proportion of CREC increasing significantly from 10.10% in 2021 to 16.36% in 2023. Of the 81 patients with CREC, 65.43% were over 60 years old. The most common specimen types were urine and sputum, with the highest proportion of patients in the intensive care unit (ICU; 32.10%). Analysis of the co-infected population revealed that ICU patients with tracheal intubation were significant risk factors. Co-infection with carbapenem-resistant Acinetobacter baumannii (CRAB) showed a concerning annual rise. Conclusions: There is urgent need for enhanced surveillance and stringent infection control measures to mitigate the spread of CREC and associated nosocomial infections. https://www.jidc.org/index.php/journal/article/view/20930Escherichia colicarbapenem-resistanceclinicalepidemiologycoinfection
spellingShingle Luyao Liu
Shihui Liu
Zhenghai Yang
Fan Wang
Huiwen Yuan
Hao Xu
Jinguan Chen
Xiaoning Li
Shifts in hospital-associated pathogens and prevalence trends of carbapenem-resistant Escherichia coli infections, 2021–2023
Journal of Infection in Developing Countries
Escherichia coli
carbapenem-resistance
clinical
epidemiology
coinfection
title Shifts in hospital-associated pathogens and prevalence trends of carbapenem-resistant Escherichia coli infections, 2021–2023
title_full Shifts in hospital-associated pathogens and prevalence trends of carbapenem-resistant Escherichia coli infections, 2021–2023
title_fullStr Shifts in hospital-associated pathogens and prevalence trends of carbapenem-resistant Escherichia coli infections, 2021–2023
title_full_unstemmed Shifts in hospital-associated pathogens and prevalence trends of carbapenem-resistant Escherichia coli infections, 2021–2023
title_short Shifts in hospital-associated pathogens and prevalence trends of carbapenem-resistant Escherichia coli infections, 2021–2023
title_sort shifts in hospital associated pathogens and prevalence trends of carbapenem resistant escherichia coli infections 2021 2023
topic Escherichia coli
carbapenem-resistance
clinical
epidemiology
coinfection
url https://www.jidc.org/index.php/journal/article/view/20930
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