Resistance trends among clinical isolates in China reported from CHINET surveillance of bacterial resistance, 2005-2014.

With the aim of gathering temporal trends on bacterial epidemiology and resistance from multiple laboratories in China, the CHINET surveillance system was organized in 2005. Antimicrobial susceptibility testing was carried out according to a unified protocol using the Kirby-Bauer method or automated systems. Results were analyzed according to Clinical and Laboratory Standards Institute (CLSI) 2014 definitions. Between 2005 and 2014, the number of bacterial isolates ranged between 22,774 and 84,572 annually. Rates of extended-spectrum ß-lactamase production among Escherichia coli isolates were stable, between 51.7 and 55.8%. Resistance of E. coli and Klebsiella pneumoniae to amikacin, ciprofloxacin, piperacillin/tazobactam and cefoperazone/sulbactam decreased with time. Carbapenem resistance among K. pneumoniae isolates increased from 2.4 to 13.4%. Resistance of Pseudomonas aeruginosa strains against all of antimicrobial agents tested including imipenem and meropenem decreased with time. On the contrary, resistance of Acinetobacter baumannii strains to carbapenems increased from 31 to 66.7%. A marked decrease of methicillin resistance from 69% in 2005 to 44.6% in 2014 was observed for Staphylococcus aureus. Carbapenem resistance rates in K. pneumoniae and A. baumannii in China are high. Our results indicate the importance of bacterial surveillance studies.

Distribution and drug resistance change of common pathogenic bacteria in hospital / 国际检验医学杂志

Objective To understand the constituent ratio and the drug resistance tendency of the common pathogens in hospital in order to provide the basis for rational clinical drug use and control of nosocomial infection .Methods The pathogenic bacteria iso‐lated from the various submitted clinical specimens and their drug resistance in our hospital from January 2012 to December 2014 were performed the retrospective analysis .Results A total of 1 325 strains of pathogenic bacteria were isolated ,among them 889 strains (67 .10% ) were Gram‐negative cocci ,284 strains(21 .43% ) were Gram‐positive cocci and 152 strains (11 .47% ) were fun‐gi .The top five of isolated strains were Escherichia coli ,Klebsiella pneumonia ,Pseudomonas aeruginos ,Staphyloccocus aureus and Acinetobacter baumannii .Escherichia coli and Klebsiella pneumonia were highly resistant to imipenem with the resistance rate of 3 .7% ,but carbapenems‐resistant strain(CRE) was detected out .The resistant rateof Pseudomonas aeruginos to meropenem was in‐creased and which to imipenem was decreased .The resistant rates of Acinetobacter baumannii to meropenem and imipenem were o‐ver 44 .83% .The detection rate of methicillin‐resistant Staphylococcus aureus (MRSA ) was decreased from 69 .05% to 54 .05% . Enterococcus faecium was highly sensitive to vancomycin ,linezolid ,teicoplanin and furadantin .But vacomycin‐resistant strains (VRE) were found .Conclusion The drug resistance of common pathogens causing nosocomial infection is serious in our hospital . Therefore ,it is very important to strengthen the monitoring of bacterial drug resistance ,rationally use antimicrobial drugs and adopt the effective measure of infection control to prevent and reduce the generation of drug‐resistant pathogens .

Analysis of bacterial distribution and resistance from exacerbation of COPD patients in C and D Classification in our emergency department / 中华急诊医学杂志

Objective To analyze the bacterial distribution and resistance of clinical isolates from exacerbation of COPD patients in C and D classification in our emergency department.Methods The sputums were taken to culture and antimicrobial susceptibility test.VITEK-2 compact automicrobe system was used to identify bacteria.Disc diffusion test was used to determine the antimicrobial resistance.Results Of 222 clinical isolates,27.0％ were Gram positive bacteria,73.0％ were Gram negative bacteria.The Gram positive bacteria mainly was Staphylococcus aureus and Streptococcus pneumoniae.The detection rates of methicillin-resistant Staphylococcus aureus (MRSA) were 50.00％.The MRSA were more resistant than methicillin-sensitive Staphylococcus aureus (MSSA),and they were all sensitive to vancomycin,linezolid or tigecycline.The Gram negative bacteria mainly was Pseudomonas aeruginosa,Escherichia coli,Klebsiella spp and Acinetobacter baumannii.Pseudomonas aeruginosa and Acinetobacter baumannii had high resistant rates.The extended spectrum β-lactamases (ESBLs) producing strains in Escherichia coli were higher than in Klebsiella spp,which had multiple drug resistance.Conclusions The bacterial resistance situation is very severely in exacerbation of COPD patients in C and D classification in our emergency department.The first isolating rate was Pseudomonas aeruginosa.Surveillance of bacterial resistance is very important and effective control measures to reduce resistance is very necessary.

Bacterial Resistance of Pathogens Caused Nosocomial Infection in ICU:Investigation and Surveillance / 中华医院感染学杂志

OBJECTIVE To investigate the distribution and drug resistance of nosocomial infection pathogens in ICU from 2005 to 2008.METHODS Antimicrobial susceptibility test of 850 clinical isolates were carried out by means of K-B method.RESULTS Among 850 isolates,Gram-negative bacilli,Gram-positive cocci and fungi accounted for 68.9%,15.8% and 15.3%,respectively.ESBLs-producing strains accounted for 50% and 55.4% in E.coli and Klebsiella spp.MRS was detected in 82.7% of Staphylococcus.Imipenem and meropenem were the most active agents against strains of Enterobacteriaceae,Acinetobacter spp and Pseudomonas aeruginosa.No VRE or VRS strains were detected.CONCLUSIONS Gram-negative bacilli are the most frequent organisms in ICU.It is necessary to conduct drug resistance supervision of nosocomial infection pathogens in ICU and take measures to control nosocomial infection spread.

Antimicrobial Resistance of Bacteria Isolated from a Hospital 2007-2008 / 中华医院感染学杂志

OBJECTIVE To investigate the resistance of clinical isolated strains to the commonly used antibacterials in our hospital 2007-2008.METHODS Clinical isolated strains and sensitivity of drugs were detected by ATB system.The result of drug sensitivity was judged by CLSI standard and analyzed with statistical software WHONET5.3.RESULTS Altogether 3150 strains bacteria were isolated,17.4% were Gram-positive strains and 82.6% were Gram-negative strains,and the top five isolates were Pseudomonas aeruginosa,Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii,and Staphylococcus aureus.The reasistance rate of Gram-positive strains to minocycline was 15.4%.Five VRE strains were isolated.Various Enterobacteriaceae bacteria were sensitive to imipenem meropenem,cefoperazone-sulbactam and piperacillin-tazobactam,and their rate was 86.5% to 97.7%.Some of Acinetobacter and Stenotrophomonas maltophilia were multidrug resistant.CONCLUSIONS It is serous that multidrug resistance of isolated strains of the patients exists in our hospital.

Surveillance of antibiotic resistance in clinical isolates from Shanghai Huashan Hospital in 2005 / 中国感染与化疗杂志

Objective To investigate the resistance of clinical isolates from Shanghai Huashan Hospital in 2005.Methods Antimicrobial susceptibility test was carried out by Kirby-Bauer method.Results were analyzed according to CLSI 2005.Results Of the 3 896 clinical isolates,gram negative bacilli and gram positive cocci accounted for 68.1% and 31.9% respectively.About 93.2%(465/499)of S.aureus isolates were identified as methicillin-resistant Staphylococcus,94.9%(260/274)of coagulase negative Staphylococcus(CNS)isolates were methicillin-resistant.No vancomycin-resistant strain was found.The resistance rates of E.faecalis and E.faecium to high level gentamicin(120 ?g)were 67.4% and 82.8% respectively.Two strains of VRE were isolated.Both were VanA type.ESBLs-producing strains accounted for 47.6%(206/433)in E.coli and 69.6%(391/562)in Klebsiella spp(K.pneumoniae and K.oxytoca).Isolates of Enterobacteriaceae were still highly sensitive to imipenem and meropenem,resistance rates being 0-4% except Citrobacter isolates,9.1% of which were resistant.However,39.3% and 59.6% of P.aeruginosa strains were resistant to the above carbapenems,respectively.Conclusions The prevalence of MRSA and MRCNS is very high.ESBLs are prevalent in E.coli and Klebsiella spp.Two glycopeptide-resistant E.faecium isolates are identified firstly in Huashan Hospital.Our data will be useful for rational use of antimicrobial agents in the treatment of bacterial infections.