Abstract
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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Acknowledgments
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.
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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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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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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). https://doi.org/10.1007/s10096-019-03673-1
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DOI: https://doi.org/10.1007/s10096-019-03673-1