Abstract:
Objective
To understand the distribution and antimicrobial resistance of common pathogens in clinical specimens in China from 2014 to 2019, provide scientific basis for the rational clinical antimicrobial use as well as the formulation and evaluation of management policies for antimicrobial clinical use.
Methods
According to China Antimicrobial Resistance Surveillance System(CARSS) technical program, antimicrobial resistance of all isolated bacteria reported by CARSS in 2014-2019 were analyzed with WHONET 5.6 software.
Results
From 2014 to 2019, the top 5 isolated Gram-positive bacteria were Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis, Streptococcus pneumoniae, and Enterococcus faecium, the top 5 isolated Gram-negative bacteria were Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii and Enterobacter cloacae. In the past 6 years, isolation rates of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase negative Staphylococcus (MRCNS) decreased from 36.0% to 30.2% and 79.8% to 75.4% respectively. Isolation rates of vancomycin-resistant Enterococcus faecalis and Enterococcus faecium showed a downward trend (from 0.8% to 0.2% and from 2.9% to 1.1% respectively). Isolation rate of penicillin-resistant Streptococcus pneumoniae (PRSP) also decreased from 4.3% to 1.6%. Isolation rates of imipenem-resistant Pseudomonas aeru-ginosa changed little (18.2%-21.0%). Antimicrobial resistance rate of Acinetobacter baumannii was more than 50%. Resistance rates of Escherichia coli and Klebsiella pneumoniae to cefotaxime decreased gradually, resistance rates of Escherichia coli to imipenem didn't change much, and were all lower than 1.5%. Resistance rate of Klebsiella pneumoniae to imipenem increased from 4.8% to 10.5%. Resistance rates of Haemophilus influenzae to all kinds of antimicrobial agents increased, resistance rate to ampicillin increased from 48.1% to 69.0%.
Conclusion
Isolation rates of MRSA, MRCNS and vancomycin-resistant Enterococcus decreased. Isolation rate of imipenem-resistant Klebsiella pneumoniae showed an upward trend, resistance of Acinetobacter baumannii to all kinds of antimicrobial agents is serious, resistance rates of Haemophilus influenzae to all kinds of antimicrobial agents increased. Management of rational use of antimicrobial agents as well as prevention and control of healthcare-associated infection should be strengthened continuously, antimicrobial resistance surveillance should be conducted well.
Key words: antimicrobial agent bacteria pathogen antimicrobial resistance surveillance multidrug-resistant organism China Antimicrobial Resistance Surveillance System