ABSTRACT
The purpose of setting project of surveillance of antimicrobial resistance is:(1)To better understand development of resistance in local hospital,or country,and to compare with data from other countries;(2)To cooperate with clinic for controlling outbreak caused by clone strain-resistance;(3)To help doctors for management of treatment;and(4)To mining the mechanisms of resistance.In this text the history of surveillance of antimicrobial resistance in Peking Union Medical College Hospital starting in 1983 to present and the achievement were ihtroduced.But the fight against resistance between human being and microorganism is eternal and difficult.The main target pathogens and antimicrobial resistance at 21 st sentry were also introduced.The paper emphasized necessity and possibility of distinguishing CA-MRSA and HA-MRSA,VRSA,VISA and hVISA,ESBLs,AmpC and carbapenemases.To pay more attention to the relationship between resistance and serotypes in Streptococcus pneumoniae,it is important to survey the emerging resistance of the new antibiotics in China,such as linezolid,tigecycline,daptomycin,ceftobiprole and new fluoroquinolones and others.It is needed to develop pharmacokinetic/pharmacodynamic(PK/PD)- breakpoints as a substitute for old breakpoints,and to introduce emerging technologies,such as data mining artificially intelligent system,geographic information system,multiplex real time PCR with advanced reading techniques and other molecular methods for routine work in Clinical microbiology,SO that we can wisely fight against microbial resistance effectively.
ABSTRACT
80% activity rate against E.coli included piperacillin/tazobactam(93.4%)、ceftazidime(86%),and amikacin(83.3%);The susceptible rate to piperacillin/tazobactam in K.pneumoniae was 84.6%. The susceptible rate to ceftazidime decreased from 82.3% to 69.9%, which was lower than to cefepime (77.2%). Over 50% of Enterobacter cloacae were resistant to ceftazidime, cefotaxime and ceftriaxone. Susceptible rates to piperacillin/tazobactam in E. cloacae,E. aerogenes,Citrobacter freundii and Serratia marcescens (67.7%-96.4%) were higher than those to cefepime (68.8%-77.5%), cefoperazone/sulbactam (59.7%-87.5%). Susceptibility to amikacin among these 4 species (70%-83.7%) was higher than to ciprofloxacin (48.1%-79.5%). All of Morganella morganii and Proteus vulgaris isolates were susceptible to meropenem and imipenem; Over 90% of the isolates were susceptible to cefepime, cefoperazone/sulbactam and piperacillin/tazobactam.The most active agent against Pseudomonas aeruginosa was meropenem (84%), followed by amikacin, piperacillin/tazobactam, ceftazidime and imipenem (72.5%-76.6%). Mutiple-drug-resistant Acinetobacter baumannii increased from 33% in 2003 to 48% in 2004. Resistance to carbapenems increased to 18% in this species in 2004. The most active agents against Burkholderia cepacia were meropenme (64.9%), cefoperazon/sulbactam (63.2%), ceftazidime (59.6%), piperacillin/tazobactam (56.1%) and cefepime (52.6%).Conclusions Carbapenems remained very high activity against Enterobacteriaceae. Increasing resistance to 10 antimicrobials agents tested among A. baumanni brought great concern. Meropenem was 4-to 16-fold more active against common gram-negative bacilli than imipenem.