Resistance reported from China antimicrobial surveillance network (CHINET) in 2018


The aim of this study is to investigate the antimicrobial susceptibility of strains isolated from the major hospitals in China. A total of 44 teaching hospitals were involved. Antimicrobial susceptibility testing was conducted by Kirby-Bauer automated systems, and results were interpreted using CLSI criteria. Totally 244,843 strains were isolated in 2018, of which gram-negative bacilli and gram-positive cocci were accounting for 71.8% and 28.2%, respectively. 39.7% of isolates were cultured from lower respiratory tract, 18.8% from urine, 14.8% from blood, 1.3% from cerebrospinal fluid, respectively. Of those, the five major species were most often isolated (65.5%, 63%, 52.3%, and 30.3%). The resistance rate of MRSA to most antimicrobial agents was significantly higher than that of MSSA strains, except for to trimethoprim-sulfamethoxazole in urine specimen. E.coli was still highly susceptible to carbapenem antibiotics, and the resistance rate was less than 5%. Carbapenem resistance among Klebsiella pneumoniae, especially cultured from cerebrospinal fluid, increased significance from 18.6 to 64.1%. The resistance rates of Pseudomonas aeruginosa to carbapenems were nearly 30% in the blood, in urine, and in the lower respiratory tract, but about 60% of that in cerebrospinal fluid. About 80% of Acinetobacter baumannii strains was resistant to imipenem and meropenem, respectively. Bacterial resistance of five major clinical isolates from cerebrospinal fluid to common antibiotics (in particular Carbapenem-resistant Klebsiella pneumoniae) currently shows an increasing trend. It is worth to emphasize the importance of serious control of hospital infection and better management of clinical use of antimicrobial agents.

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We gratefully acknowledge the contributions of the members of CHINET for collection of the isolates tested in this study. Their names and affiliations are as follows: Yingchun Xu and Xiaojiang Zhang from the Peking Union Medical College Hospital; Zhaoxia Zhang and Ping Ji from the First Affiliated Hospital of Xinjiang Medical University; Mei Kang and Chao He from West China Hospital, Sichuan University; Chuanqing Wang and Leiyan He from the Children’s Hospital of Fudan University; Yuanhong Xu and Ying Huang from the First Affiliated Hospital of Anhui Medical University; Zhongju Chen and Ziyong Sun from Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology; Yuxing Ni and Jingyong Sunfrom Ruijin Hospital, Shanghai Jiaotong University School of Medcine; Yunzhuo Chu and Sufei Tian from the First Affiliated Hospital of China Medical University; Zhidong Hu and Jin Li from Tianjin Medical University General Hospital; Yunsong Yu and Jie Lin from Sir Run Run Shaw Hospital, Zhejiang University School of Medicine; Bin Shan and Yan Du from the First Affiliated Hospital of Kunming Medical University; Sufang Guo and Yanyan Wang from the First Affiliated Hospital of Inner Mongolia Medical University; Lianhua Wei and Xin Wang from the Gansu Provincial Hospital; Hong Zhang and Chun Wang from the Children’s Hospital of Shanghai; Yunjian Hu and Xiaoman Ai from Beijing Hospital; Chao Zhuo and Danhong Su from the First Affiliated Hospital of Guangzhou Medical University; Ruizhong Wang and Hua Fang from the Pudong New Area People’s Hospital; Bixia Yu from the Zhejiang Ningbo Zhenhai Longsai Hospital; Ping Gong and Miao Song from the People’s Hospital of Zigui, Hubei Province; Dawen Guo and Jinying Zhao from the First Affiliated Hospital of Harbin Medical University; Wen’en Liu and Yanming Li from Xiangya Hospital, Central South University; Yan Jin and Yueling Wang from Shandong Provincial Hospital; Kaizhen Weng and Yirong Zhang from the Jinjiang Municipal Hospital; Xuesong Xu and Chao Yan from the China-Japan Union Hospital, Jilin University; Xiangning Huang and Hua Yu from the Sichuan Provincial People’s Hospital; Yi Li and Shanmei Wang from the Henan Provincial People’s Hospital; Lixia Zhang and Juan Ma from the Shaanxi Provincial People’s Hospital; Shuping Zhou and Jiangwei Ke from the Jiangxi Provincial Children’s Hospital; Lei Zhu and Jinhua Meng from the Children’s Hospital of Shanxi; Wenqi Song and Fang Dong from the Beijing Children’s Hospital, Capital Medical University; Han Shen and Wanqing Zhou from the Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing; Gang Li and Wei Jia from the General Hospital of Ningxia Medical University; Jinsong Wu and Yuemei Lu from the Shenzhen People’s Hospital; Jihong Li from the Second Hospital of Hebei Medical University; Jiangshan Liu from Jinchang Hospital of integrated traditional Chinese and Western Medicine; Longfeng Liao from The People’s Hospital of Ganxian; Hongqin Gu from Guangrao County People's Hospital; Lin Jiang from The People’s Hospital of Huixian, Henan Province; Wen He from Central Hospital of Yingkou Development Zone, Liaoning Province; Shunhong Xue from Huzhu County People's Hospital, Qinghai Province; Jiao Feng from The People’s Hospital of Linshui, Sichuan Province; Rui Dou from Lixin County People's Hospital; and Chunlei Yue from Jiutai People's Hospital.

Funding information

This work was supported in part by the Pfizer Investigator Initiated Research (grant WI207259) and the National Natural Science Foundation of China (grant 81871690).

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Correspondence to Demei Zhu.

Ethics declarations

The study is conducted on already available data. Ethical approval was approved by the Institutional Review Board of Huashan Hospital, Fudan University (Number:2018-408).

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The authors declare that they have no conflict of interest.


The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Hu, F., Guo, Y., Yang, Y. et al. Resistance reported from China antimicrobial surveillance network (CHINET) in 2018. Eur J Clin Microbiol Infect Dis 38, 2275–2281 (2019) doi:10.1007/s10096-019-03673-1

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  • Bacterial resistance surveillance
  • Antimicrobial susceptibility testing
  • Methicillin-resistant Staphylococcus
  • Carbapenem-resistant gram-negative bacilli