Antimicrobial Resistance and Resistance Determinant Insights into Multi-Drug Resistant Gram-Negative Bacteria Isolates from Paediatric Patients in China

Figures & data

Table 1 List of Primers Used in This Study

Resistance Genes	Primers Pair Sequences	Amplicon Size (bp)	Annealing Temperature (°C)	References
mcr-1	ATGATGCAGCATACTTCTGTG	1626	56	^Citation20
	TCAGCGGATGAATGCGGTG
blaNDM	TGCGGGGTTTTTAATGCTG	785	53	^Citation21
	TGGCTCATCACGATCATGC
blaKPC	ATGTCACTGTATCGCCGTC	883	54	^Citation21
	TTACTGCCCGTTAACGCC
blaTEM	AGGAAGAGTATGATTCAACA	531	57	^Citation21
	CTCGTCGTTTGGTATGGC
blaSHV	GGTTATGCGTTATATTCGCC	866	57	^Citation21
	TTAGCTTTGCCAGTGCTC
blaOXA48	TTGGTGGCATCGATTATCGG	745	55	^Citation21
	GAGCACTTCTTTTGTGATGGC
blaSME	AACGGCTTCATTTTTGTTTAG	831	55	^Citation21
	GCTTCCGCAATAGTTTTATCA
blaCMY	CTGACAGCCTCTTTCTCCA	504	56	^Citation21
	GCCAAACAGACCAATGCT
blaVIM	GTTAAAAGTTATTAGTAGTTTATTG	799	60	^Citation21
	CTACTCGGCGACTGAGC
blaIMP	ATGAGCAAGTTATCTGTATTC	741	60	^Citation21
	TTAGTTGCTTGGTTTTGATGG
blaGES	ATGCGCTTCATTCACGCAC	864	57	^Citation22
	CTATTTGTCCGTGCTCAGG
blaCARB	AAAGCAGATCTTGTGACCTATTC	588	56	^Citation22
	TCAGCGCGACTGTGATGTATAAAC
blaPER	AGTCAGCGGCTTAGATA	978	56	^Citation22
	CGTATGAAAAGGACAATC
blaVEB	GCGGTAATTTAACCAGA	961	57	^Citation22
	GCCTATGAGCCAGTGTT
blaCTX-M	TTTGCGATGTGCAGTACCAGTAA	544	57	^Citation22
	CGATATCGTTGGTGGTGCCATA

Figure 1 Distribution of isolated Gram-negative pathogens from Shenzhen Children’s Hospital, China.

Table 2 Resistance Patterns of Gram-Negative Bacteria for Selected Antibiotics and Antibiotics Classes

Antibiotic Classes	Name of Antibiotics	E. coli (n=68)	K. pneumoniae (n=30)	E. cloacae (n=24)	P. aeruginosa (n=22)	A. baumannii (n=10)	S. typhimurium (n=8)	S. maltophilia (n=2)	P. vulgaris(n=2)	B. cepacian (n=2)	E. meningoseptica (n=1)	C. freundii (n=1)
Cephalosporin	Ceftazidime	15	1	4	4	1	0	1	0	0	1	0
	Ceftriaxone	37	15	12	10	2	4	1	1	2	0	0
	Cefuroxime	33	16	14	8	1	5	1	0	2	1	0
	Cefuroxime Axetile	38	13	13	9	2	3	1	2	2	1	0
	Ertapenem	5	3	0	2	0	0	0	0	0	0	0
	Cefepime	14	4	2	1	0	1	0	0	0	0	0
	Cefoxitin	17	10	3	4	0	1	0	0	0	0	0
	Cefazolin	24	15	5	8	1	4	0	2	1	0	0
Penicillin	Amoxicillin	18	7	3	4	0	0	0	0	1	0	0
	Ampicillin sulbactam	30	11	6	13	5	3	0	1	0	1	1
	Piperacillin-Tazobactam	8	3	2	2	1	0	0	0	0	0	0
Aminoglycoside	Amikacin	1	2	1	0	0	0	1	0	0	0	0
	Tobramycin	8	6	1	2	1	0	0	0	0	0	0
	Imipenem	3	2	0	1	0	0	0	0	0	0	0
Quinolones	Ciprofloxacin	25	10	8	7	2	1	0	0	1	1	0
	Levofloxacin	16	4	1	5	2	1	0	1	1	0	0
Monobactam	Aztreonam	16	10	10	8	2	1	0	1	1	0	0
Nitrofuran Derivative	Nitrofurantoin	13	5	3	3	2	2	0	0	0	1	1
Sulphonamides	Trimethoprim/Sulfamethoxazole	39	12	9	12	7	1	0	1	0	1	1
Polymyxin	Colistin	1	1	0	1	0	0	0	0	0	0	0
Tetracycline	Tigecycline	4	6	1	1	1	1	1	0	0	0	0

Figure 2 (A) Number of isolates in which resistance is detected for each antibiotic. (B) Detection percentages of resistance to each antibiotic.

Table 3 Distribution of MDS, SDR, MDR, and XDR Pattern of Gram-Negative Bacteria

Isolated Strains	Total	MDS	SDR	MDR	XDR
C. freundii	1	0	1	0	0
E. meningoseptica	1	0	0	1	0
B. cepacia	2	0	0	2	0
P. vulgaris	2	0	0	2	0
S. maltophilia	2	0	0	2	0
S. typhimurium	8	2	1	4	1
A. baumannii	10	2	0	6	2
P. aeruginosa	22	1	2	17	2
E. cloacae	24	0	1	23	0
K. pneumoniae	30	3	0	24	3
E. coli	68	6	8	41	13
Total	170	14	13	122	21

Notes: MDS, susceptible to all antibiotic classes; SDR, resistant to single antibiotic class; MDR, resistant to at least one agent in three or more antimicrobial categories; XDR, resistant to at least one agent in all but two or fewer antimicrobial categories (ie, bacterial isolates remain susceptible to only one or two categories). Source: Based on definitions by Magiorakos et al, 2012.²³

Table 4 Prevalence of Drug Resistance Determinant (Genes) in Isolated Gram-Negative Bacteria

Drug Resistance Determinant	E. coli (n=68)	K. pneumoniae (n=30)	E. cloacae (n=24)	P. aeruginosa (n=22)	A. baumanni (n=10)	S. typhimurium (n=8)	S. maltophilia (n=2)	P. vulgaris (n=2)	B. cepacian (n=2)	E. meningoseptica (n=1)	C. freundii (n=1)	Total n=170
mcr-1	2	0	0	0	0	1	0	0	0	0	0	3
blaCTX-M	37	19	18	14	6	3	2	0	1	1	0	101
blaNDM-1	15	6	5	1	2	0	0	0	0	0	1	30
blaKPC	21	12	12	8	01	1	1	0	1	0	1	58
blaTEM	30	16	9	7	3	3	0	0	1	1	0	70
blaSHV	16	16	12	7	3	3	0	0	1	1	0	59
blaGES	11	3	1	5	2	2	0	0	0	0	0	24
blaCARB	5	2	2	2	0	1	1	0	1	0	0	14
blaPER	0	0	0	0	0	0	0	0	0	0	0	0
blaVEB	0	0	0	0	0	0	0	0	0	0	0	0
blaOXA48	14	4	7	0	1	2	1	1	1	1	0	32
blaSME	0	0	0	0	0	0	0	0	0	0	0	0
blaVIM	4	6	2	2	1	1	0	0	0	0	0	16

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