RESUMO
Objective To investigate the susceptibility and resistance profile of clinical isolates in Hunan Yongzhou Hospital during 2016 and 2017. Methods Antimicrobial susceptibility testing was carried out according to a unified protocol using KirbyBauer method or automated systems. Results were analyzed according to CLSI 2016 breakpoints. Results A total of 6 354 clinical isolates were collected from January 2016 to December 2017, of which 4 876(76.7％)were gram-negative bacteria, and 1 478(23.3％)were gram-positive bacteria. The top five bacterial species were Escherichia coli(33.0％), Klebsiella(17.0％), Staphylococcus aureus(9.6％), Acinetobacter(8.6％), and Pseudomonas aeruginosa(7.4％). The prevalence of methicillin-resistant Staphylococcus aureus(MRSA)was 33.8％, and prevalence of methicillin-resistant coagulase negative Staphylococcus(MRCNS)was 76.2％. The resistance rates of methicillin resistant strains(MRSA and MRCNS)to most of the tested drugs were significantly higher than those of methicillin sensitive strains(MSSA and MSCNS). No vancomycin or linezolid resistant staphylococci were identified. The resistance rate of Enterococcus faecium to most antimicrobial agents was significantly lower than that of Enterococcus faecium. No enterococcal isolate was resistant to vancomycin or linezolid. The non-meningitis S. pneumoniae strains isolated from children showed slightly higher resistance rate to penicillin(20.8％)than the strains isolated from adults(13.3％). The prevalence of extended spectrum beta-lactamases(ESBLs)in Escherichia coli and Klebsiella pneumoniae was 48.0％ and 35.7％, respectively. Most Enterobacteriaceae strains were highly sensitive to carbapenem antibiotics, showing lower resistancerate(<4％). The prevalence of carbapenem-resistant Klebsiella pneumoniae was 18.8％, and the prevalence of carbapenem-resistant E. cloacae was 14.5％. The prevalence of Acinetobacter baumannii strain resistant to imipenem and meropenem was 76.4％ and 78.6％, respectively. Conclusions Bacterial resistance is still serious. It is necessary to strengthen the monitoring of bacterial resistance, infection control, and rational use of antibiotics.
RESUMO
Objective To investigate the susceptibility profile of clinical isolates in the First Affiliated Hospital of Guangzhou Medical University during 2015-2017. Methods Susceptibility test was carried out using Kirby-Bauer method or automated systems. Results were analyzed according to CLSI 2017 breakpoints. Results A total of 17 645 clinical isolates were isolated from January 2015 to December 2017, including 3 091(17.5％)gram positive and 14 554(82.5％)gram negative bacteria. Methicillinresistant S. aureus(MRSA)and coagulase-negative Staphylococcus(MRCNS)accounted for 50.7％ and 77.9％, respectively. No staphylococcal isolates were found resistant to vancomycin, teicoplanin or linezolid. E. faecalis strains showed much lower resistance rate to most drugs tested than E. faecium. Nine(0.8％)E. faecalis isolates were found resistant to vancomycin. A total of 227 strains of the non-meningitis S. pneumoniae were tested, 44.1％ of which were isolated from adults and 55.9％ from children. Most of the S. pneumoniae isolated from adults and children were susceptible to penicillin(88.0％ and 81.1％, respectively). E. coli showed the highest proportion in three years. ESBLs were produced in 53.3％ of E. coli and 28.5％ of Klebsiella spp. A total of 255 strains of carbapenem-resistant Enterobacteriaceae(3.7％), 665 strains of carbapenem-resistant Pseudomonas aeruginosa(26.2％)and 900 strains of carbapenem-resistant Acinetobacter baumannii(57.5％)were identified. The annual change of prevalence was insignificant. A total of 141 strains of extensively-drug resistant Pseudomonas aeruginosa(5.6％)and 458 strains of extensively-drug resistant A. baumannii(29.3％)were identified, showing decreasing prevalence from 2015 to 2017. Conclusions The bacterial resistance in this hospital is relatively stable in the past three years, but it is still necessary to strengthen hospital infection control and management, and maintain good practice in surveillance of bacterial resistance.
RESUMO
Objective To investigate the antimicrobial resistance profile of the clinical isolates collected from selected hospitals across China. Methods Twenty-nine general hospitals and five children's hospitals were involved in this program. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems. Results were interpreted according to CLSI 2017 breakpoints. Results A total of 190 610 clinical isolates were collected from January to December 2017, of which gram negative organisms accounted for 70.8％ (134 951/190 610) and gram positive cocci 29.2％ (55 649/190 610). The prevalence of methicillin-resistant strains was 35.3％ in S. aureus (MRSA) and 80.3％ in coagulase negative Staphylococcus (MRCNS) on average. MR strains showed much higher resistance rates to most of the other antimicrobial agents than MS strains. However, 91.6％ of MRSA strains were still susceptible to trimethoprim-sulfamethoxazole, while 86.2％ of MRCNS strains were susceptible to rifampin. No staphylococcal strains were found resistant to vancomycin. E. faecalis strains showed much lower resistance rates to most of the drugs tested (except chloramphenicol) than E. faecium. Vancomycin-resistant Enterococcus (VRE) was identified in both E. faecalis and E. faecium. The identified VRE strains were mainly vanA, vanB or vanM type based on phenotype or genotype. The proportion of PSSP or PRSP strains in the non-meningitis S.pneumoniae strains isolated from children decreased but the proportion of PISP strains increased when compared to the data of 2016. Enterobacteriaceae strains were still highly susceptible to carbapenems. Overall, less than 10％ of these strains (excluding Klebsiella spp.) were resistant to carbapenems. The prevalence of imipenem-resistant K. pneumoniae increased from 3.0％ in 2005 to 20.9％ in 2017, and meropenem-resistant K. pneumoniae increased from 2.9％ in 2005 to 24.0％ in 2017, more than 8-fold increase. About 66.7％ and 69.3％ of Acinetobacter (A. baumannii accounts for 91.5％) strains were resistant to imipenem and meropenem, respectively. Compared with the data of year 2016, P. aeruginosa strains showed decreasing resistance rate to carbapenems. Conclusions Bacterial resistance is still on the rise. It is necessary to strengthen hospital infection control and stewardship of antimicrobial agents. The communication between laboratorians and clinicians should be further improved in addition to surveillance of bacterial resistance.