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    • 1  Antimicrobial resistance of bacteria: surveillance report from China Antimicrobial Resistance Surveillance System in 2014-2019
    China Antimicrobial Resistance Surveillance System
    2021, 20(1):15-31. DOI: 10.12138/j.issn.1671-9638.20216170
    [Abstract](495) [HTML](4644) [PDF 1.05 K](1476)
    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.
    2  Antimicrobial resistance of bacteria from bile: surveillance report from China Antimicrobial Resistance Surveillance System in 2014-2019
    China Antimicrobial Resistance Surveillance System
    2021, 20(1):77-85. DOI: 10.12138/j.issn.1671-9638.20216177
    [Abstract](129) [HTML](857) [PDF 693.00 Byte](693)
    Abstract:
    Objective To understand the distribution and antimicrobial resistance of bacteria in biliary tract infection in China, and provide reference for clinical antimicrobial choice. Methods According to China Antimicrobial Resistance Surveillance System(CARSS) technical program, data of bacteria isolated from bile specimen and antimicrobial susceptibility testing results reported by CARSS member hospitals in 2014-2019 were analyzed with WHONET 5.6 software, the same bacteria from the same patient was only adopted the first strain. Results A total of 268 016 bacterial strains were analyzed, the top 8 were Escherichia coli (30.9%), Klebsiella pneumoniae (12.7%), Enterococcus faecium (10.1%), Enterococcus faecalis (8.6%), Pseudomonas aeruginosa (4.9%), Enterobacter cloacae (4.5%), Acinetobacter baumannii (2.2%), and Citrobacter freundii (1.8%). Antimicrobial susceptibility testing results of 6 years showed that resistance rates of Escherichia coli and Klebsiella pneumoniae to third-generation cephalosporins were 33.7%-65.6% and 23.6%-43.5% respectively, to quinolones were 48.9%-56.6% and 22.0%-28.5% respectively, to carbapenems were 1.1%-3.7% and 3.5%-7.6% respectively; resistant rates of Pseudomonas aeruginosa and Acinetobacter baumannii to cefoperazone/sulbactam were 13.4%-19.0% and 29.3%-42.7% respectively, to carbapenems were 18.0%-28.0% and 44.5%-59.9% respectively; resistance rates of Enterococcus faecium and Enterococcus faecalis to vancomycin were 0.6%-1.7% and 0.3%-0.7% respectively. Conclusion Gram-negative bacilli are predominant pathogens in biliary tract infection in China, the mjor bacteria were Enterobacteriaceae; pathogens are resistant to multiple antimicrobial agents, clinical antimicrobial choice should refer to antimicrobial resistance surveillance results.
    3  Antimicrobial resistance of bacteria isolated from patients in department of neurology: surveillance report from China Antimicrobial Resistance Surveillance System, 2021
    全国细菌耐药监测网
    2023(10):1193-1201. DOI: 10.12138/j.issn.1671-9638.20233801
    [Abstract](46) [HTML](191) [PDF 808.88 K](170)
    Abstract:
    Objective To understand the species distribution and antimicrobial resistance characteristics of pathogenic bacteria isolated from patients in department of neurology in China, and provide a basis for the prevention and control of healthcare-associated infection as well as the rational use of antimicrobial agents in clinical. Methods Bacterial resistance monitoring data of patients in department of neurology in member units of China Antimicrobial Resistance Surveillance System in 2021 were selected, and analyzed with WHONET 5.6 software. Results In 2021, a total of 127 506 strains of bacteria were isolated from patients in department of neurology. Gram-positive bacteria and Gram-negative bacteria accounted for 21.6% (n=27 526) and 78.4% (n=99 980), respectively. The major specimens were sputum (n=67 782, 53.2%), urine(n=37 789, 29.6%)and blood (n=10 599, 8.3%). Isolation rates of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase negative Staphylococcus (MRCNS) were 31.9% and 66.4%, respectively. No Staphylococcus strains were found to be resistant to vancomycin and teicoplanin. Resistance rates of Enterococcus faecalis and Enterococcus faecium to vancomycin were 0.4% and 1.7%, respectively. Among Enterobacterales, resistance rates of Klebsiella pneumoniae to imipenem and meropenem were 9.8% and 11.4%, which were higher than those of Escherichia coli (1.2% and 1.3%, respectively). Acinetobacter baumannii had a high resistance rate to carbapenems, with resistance rates to imipenem and meropenem being 52.0% and 54.4%, respectively. Conclusion Bacteria isolated from patients in department of neurology are mainly Gram-negative bacteria, mostly from lower respiratory tract specimens. Antimicrobial resistance of the frequently clinically isolated bacteria is severe. Cntinuous monitoring on bacterial resistance should be carried out to promote the rational use of antimicrobial agents.
    4  Antimicrobial resistance of bacteria from peritoneal effusion specimens:surveillance report from China Antimicrobial Resistance Surveillance System in 2014-2019
    China Antimicrobial Resistance Surveillance System
    2021, 20(2):134-144. DOI: 10.12138/j.issn.1671-9638.20216176
    [Abstract](72) [HTML](592) [PDF 604.00 Byte](418)
    Abstract:
    Objective To understand the distribution characteristics and antimicrobial resistance of pathogenic bacteria from peritoneal effusion specimens in China, and provide evidence for clinical rational selection of antimicrobial agents. Methods All the surveilled data were from strains isolated from peritoneal effusion specimens reported by member hospitals of China Antimicrobial Resistance Surveillance System (CARSS) from January 2014 to September 2019, the first strain of the identical bacteria from the same patient was adopted to be analyzed finally, and repetitive strains were excluded. Results A total of 244 744 strains of non-repetitive bacteria from peritoneal effusion were isolated in 2014-2019, and the number of isolated strains showed an upward trend each year. The top 4 isolated strains were Escherichia coli (32.2%), Klebsiella pneumoniae (9.2%), Enterococcus faecium (7.3%) and Staphylococcus epidermidis (5.8%). Enterobacteriales had higher resistance rates to ceftazidime, cefotaxime and levofloxacin, and lower resistance rates to imipenem and amikacin, but Klebsiella pneumoniae had higher resistance rates to imipenem and amikacin than other Enterobacteriales. Among non-fermentative bacteria, Pseudomonas aeruginosa had low resistance to amikacin (2.3%-5.2%), Acinetobacter baumannii had high resistance to cephalosporins, carbapenems and quinolones (most were >50%), resistance rates to minocycline were 14.4%-28.4%. Isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) decreased year by year, linezolid vancomycin and teicoplanin resistant strain was not found. Resistance rates of MRSA to all antimicrobial agents were all higher than those of methicillin-susceptible Staphylococcus aureus (MSSA). Enterococcus faecalis and Enterococcus faecium were the most common Enterococcus species. Except linezolid and minocycline, the overall resistances rates of Enterococcus faecalis to other antimicrobial agents were all lower than that of Enterococcus faecium. Conclusion Bacteria from peritoneal effusion are widely distributed in China, mainly Gram-negative bacilli such as Escherichia coli and Klebsiella pneumoniae, isolation rate is increasing year by year; antimicrobial resistance strains is common, the growth trend of bacterial resistance in recent 6 years is relatively stable, resistance rate of individual strains to specific antimicrobial agents present a downward trend year by year. Surveillance on some strains such as Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii still need to be strengthened. Rational selection of antimicrobial agents should be based on antimicrobial susceptibility testing results.
    5  Antimicrobial resistance of bacteria from wound and pus specimens:surveillance report from China Antimicrobial Resistance Surveillance System in 2014-2019
    China Antimicrobial Resistance Surveillance System
    2021, 20(2):145-156. DOI: 10.12138/j.issn.1671-9638.20216185
    [Abstract](75) [HTML](486) [PDF 634.00 Byte](403)
    Abstract:
    Objective To analyze the distribution as well as antimicrobial susceptibility and resistance of bacteria isolated from wound and pus specimens from member hospitals of China Antimicrobial Resistance Surveillance System(CARSS). Methods Antimicrobial susceptibility testing data of bacteria from wound and pus specimens from member hospitals of CARSS in 2014-2019 were analyzed, antimicrobial susceptibility testing results were interpreted according to Clinical and Laboratory Standards Institute (CLSI) and analyzed by WHONET 5.6 software. Results A total of 1 182 888 bacterial strains from wound and pus were isolated in 2014-2019, the top 5 bacteria were Escherichia coli (27.8%), Staphylococcus aureus (21.0%), Klebsiella pneumoniae (9.0%), Pseudomonas aeruginosa (6.7%), and Staphylococcus epidermidis (3.8%). In 2014-2019, isolate rates of methicillin-resistant Staphylococcus aureus (MRSA) were 30.8%, 30.0%, 29.9%, 29.4%, 27.4% and 26.9% respectively, isolate rates of methicillin-resistant coagulase negative Staphylococcus (MRCNS) were 75.2%, 76.1%, 73.0%, 72.1%, 71.3% and 71.0% respectively, linezolid- and vancomycin-resistant Staphylococcus were not found. Resistance rates of Enterococcus faecium to common antimicrobial agents were significantly higher than those of Enterococcus faecalis, resistance rates of Enterococcus faecalis and Enterococcus faecium to vancomycin were 0.2%-0.7% and 0.7%-2.0% respectively, to linezolid were 1.4%-2.3% and 0.4%-1.5% respectively, and to teicoplanin were 0.3%-0.7% and 0.9%-1.9% respectively. Resistance rate of Streptococcus pneumoniae to penicillin decreased from 8.1% in 2015 to 1.4% in 2019, vancomycin- and linezolid-resistant Streptococcus pneumoniae was not found. Resistance rates of Escherichia coli to cefotaxime and ceftriaxone were both above 50% in 2014-2016, slightly lower than 50% in 2017-2019, resistance rate to quinolones was>38%, to trimethoprim-sulfamethoxazole was above 58%, and susceptibility rates to imipenem and meropenem were the highest, both were higher than 98%, followed by cefoperazone/sulbactam (>83%). Resistance rates of Klebsiella pneumoniae to ceftriaxone, cefotaxime, quinolones, and trimethoprim-sulfamethoxazole were all lower than those of Escherichia coli, but resistance rate to carbapenems was higher than that of Escherichia coli, resistance rate to cefoperazone/sulbactam was <10%. Resistance rates of Pseudomonas aeruginosa to cefoperazone/sulbactam, ceftazidime, cefepime, imipenem, meropenem, and ciprofloxacin were all <15%, to amikacin were all <10%, the overall resistance rate of Acinetobacter baumannii was higher than that of Pseudomonas aeruginosa, resistance rates to cefepime, imipenem, meropenem and ciprofloxacin were all >47%, while resistance rates to minocycline was <25%. Conclusion Pathogens isolated from wound and pus are mainly Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae and Pseudomonas aeruginosa, antimicrobial resistance rate of bacteria is high, change of antimicrobial resistance of bacteria from wound and pus should be surveilled regularly to provide basis for rational use of antimicrobial agents and clinical treatment experience.
    6  Antimicrobial resistance of bacteria isolated from patients in department of rheumatology and immunology: surveillance report from China Antimicrobial Resistance Surveillance System, 2021
    全国细菌耐药监测网
    2023(10):1177-1184. DOI: 10.12138/j.issn.1671-9638.20233803
    [Abstract](63) [HTML](182) [PDF 804.58 K](136)
    Abstract:
    Objective To understand the distribution and antimicrobial susceptibility of clinically isolated bacteria from department of rheumatology and immunology in China in 2021. Methods According to China Antimicrobial Resistance Surveillance System (CARSS) program, information of clinically isolated bacteria from department of rheumatology and immunology reported by all CARSS member hospitals in 2021 were statistically analyzed. Antimicrobial susceptibility testing results were interpreted according to the standards from Clinical and Laboratory Stan-dards Institute (CLSI). Results In 2021, 28 863 strains of non-repetitive bacteria were isolated from patients in the department rheumatology and immunology, with Gram-negative bacteria and Gram-positive bacteria accounting for 72.0% (n=20 784) and 28.0% (n=8 079), respectively. The top five detected bacterial strains were Escherichia coli (n=9 825, 34.0%), Klebsiella pneumoniae (n=3 222, 11.2%), Staphylococcus aureus (n=3 002, 10.4%), Pseudomonas aeruginosa (n=1 793, 6.2%) and Enterococcus faecalis (n=866, 3.0%). The specimens were mainly from urine (n=13 496, 46.8%), sputum (n=7 597, 26.3%), blood (n=2 402, 8.3%) and pus (n=1 243, 4.3%). Isolation rates of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coa-ulase negative Staphylococcus (MRCNS) were 22.8% and 67.2%, respectively. The resistance rate of MRCNS to linezolid was 0.1%, and no strains were found to be resistant to vancomycin and teicoplanin. Resistance rates of Enterococcus faecalis and Enterococcus faecium to vancomycin and linezolid were 0.2%-4.0%. Resistance rate of Streptococcus pneumoniae isolated from non-cerebrospinal fluid specimens to penicillin was 2.8%. Resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii to impenem were 9.6% and 20.2%, respectively. Resis-tance rates of Escherichia coli to cefotaxime and imipenem were 41.0% and 0.9%, respectively. Resistance rates of Klebsiella pneumoniae to cefotaxime and imipenem were 18.2% and 4.5%, respectively. Resistance rate of Haemophilus influenzae to ampicillin was 69.4%. Conclusion Clinically isolated bacteria from patients in department of rheumatology and immunology mainly come from urine specimens, and antimicrobial resistance of bacteria still remains at a high level.
    7  Change in antimicrobial resistance of clinically isolated non-fermentative Gram-negative bacilli: surveillance report from China Antimicrobial Resistance Surveillance System in 2014-2019
    China Antimicrobial Resistance Surveillance System
    2021, 20(1):70-76. DOI: 10.12138/j.issn.1671-9638.20216182
    [Abstract](112) [HTML](1042) [PDF 1.55 K](736)
    Abstract:
    Objective To understand the change in antimicrobial resistance of clinical non-fermentative Gram-negative bacilli in China. Methods Surveillance on antimicrobial resistance was carried out according to the requirements of China Antimicrobial Resistance Surveillance System(CARSS), referring to Clinical & Laboratory Stan-dards Institute(CLSI) standard, clinical data of non-fermentative Gram-negative bacilli reported to CARSS by more than 1 000 hospitals in China from 2014 to 2019 were summarized and analyzed. Results Non-fermentative Gram-negative bacilli were mainly isolated from respiratory tract specimens(sputum and bronchoalveolar lavage fluid), urine, pus, and blood, accounting for 83.6%, 6.5%, 4.0% and 3.6% respectively. Isolation rates of Pseudomonas aeruginosa, Acinetobacter baumannii, Stenotrophomonas maltophilia, and Burkholderia cepacia were 8.8%, 7.3%, 2.1% and 0.5% respectively. Susceptibility rates of Pseudomonas aeruginosa to polymyxin B, amikacin and gentamicin were 96.9%-98.2%, 89.1%-94.0% and 80.1%-86.4% respectively; susceptibility rates to piperacillin and aztreonam were 66.7%-72.8% and 58.8%-62.4% respectively; susceptibility rates to other antimicrobial agents were 70.4%-81.7%. Susceptibility rates of Acinetobacter baumannii to polymyxin B, amikacin and minocycline were 96.2%-98.0%, 51.0%-58.0% and 59.4%-63.4% respectively, to other antimicrobial agents were 35.8%-50.0%. Susceptibility rates of Stenotrophomonas maltophilia to minocycline, sulfamethoxazole and levofloxacin were 93.0%-95.3%, 89.3%-91.4% and 85.0%-86.6% respectively, susceptibility rates to ticarcillin/clavulanic acid and chloramphenicol were 37.4%-50.3% and 46.6%-51.1% respectively. Susceptibility rates of Burkholderia cepacia to ticarcillin/clavulanic acid and chloramphenicol were 18.5%-37.0% and 54.4%-62.2% respectively, susceptibility rates to other antimicrobial agents maintained 64.7%-86.8%. Isolation rate of carbapenem-resistant Pseudomonas aeruginosa decreased, while isolation rate of carbapenem-resis-tant Acinetobacter baumannii increased first and then decreased. Conclusion There is no significant change in susceptibility of non-fermentative Gram-negative bacilli to commonly used antimicrobial agents, isolation rates of carbapenem-resistant Pseudomonas aeruginosa and carbapenem-resistant Acinetobacter baumannii showed a downward trend.
    8  Antimicrobial resistance of bacteria from bronchoalveolar lavage fluid: surveillance report from China Antimicrobial Resistance Surveillance System in 2014-2019
    China Antimicrobial Resistance Surveillance System
    2021, 20(1):61-69. DOI: 10.12138/j.issn.1671-9638.20216174
    [Abstract](110) [HTML](715) [PDF 810.00 Byte](577)
    Abstract:
    Objective To investigate the changes of antimicrobial resistance of bacteria from bronchoalveolar lavage fluid (BALF) specimens in China. Methods Data of BALF specimens were extracted from China Antimicrobial Resistance Surveillance System (CARSS) surveillance report in 2014-2019, antimicrobial resistance was analyzed by WHONET 5.6 software. Results From 2014 to 2019, a total of 140 321 strains of bacteria were isolated from BALF specimens, the top 5 bacteria were Pseudomonas aeruginosa (19.1%), Acinetobacter baumannii (16.6%), Klebsiella pneumoniae (16.6%), Staphylococcus aureus (7.8%) and Streptococcus pneumoniae (6.2%). Antimicrobial susceptibility data of 6 years showed that isolation rates of methicillin-resistant Staphylococcus aureus (MRSA) were 52.3%, 55.5%, 51.4%, 42.8%, 40.6% and 37.9% respectively, vancomycin-, teicoplanin- and line-zolid-resistant Staphylococcus aureus were not found. The overall resistance rates of Streptococcus pneumoniae to penicillin were 1.0%-4.4%, penicillin-nonsusceptible Streptococcus pneumonia (PNSP) showed a downward trend year by year; except for compound sulfamethoxazole, resistance of Klebsiella pneumoniae to other antimicrobial agents increased year by year, especially for carbapenems, resistance was significantly higher than that of Esche-richia coli and Enterobacter cloacae. Among non-fermentative bacteria, resistance rates of Pseudomonas aeruginosa were relatively low, most were below 30%; resistance rates of Acinetobacter baumannii to all tested antimicrobial agents didn’t change much generally, but its resistance rates to most antimicrobial agents were relatively high, most were more than 50%. Conclusion Gram-negative bacilli are the main pathogens isolated from BALF specimens in China, and antimicrobial resistance is serious. It is suggested that high-quality BALF specimens should be sent for clinical examination, pathogen detection should be paid attention to, and antimicrobial agents should be used rationa-lly according to the corresponding antimicrobial resistance surveillance data.
    9  Antimicrobial resistance of clinically isolated bacteria from outpatients: surveillance report from China Antimicrobial Resistance Surveillance System in 2014-2019
    China Antimicrobial Resistance Surveillance System
    2021, 20(1):32-43. DOI: 10.12138/j.issn.1671-9638.20216184
    [Abstract](130) [HTML](610) [PDF 747.00 Byte](762)
    Abstract:
    Objective To surveil the distribution and antimicrobial susceptibility of clinically isolated bacteria from outpatients in China from 2014 to 2019. Methods According to China Antimicrobial Resistance Surveillance System (CARSS) program, clinically isolated bacteria and antimicrobial susceptibility testing results of outpatients reported by all CARSS member hospitals in 2014-2019 were analyzed by WHONET 5.6 software. Results The total number of bacteria isolated from outpatients in 2014-2019 were 53 243-91 692 strains, Gram-negative bacteria accounted for 75.3%, 57.3%, 58.3%, 58.5%, 60.5% and 60.9% respectively, Gram-positive bacteria accounted for 24.7%, 42.7%, 41.7%, 41.5%, 39.5% and 39.1% respectively. Isolation rates of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase negative Staphylococcus (MRCNS) were 25.1%-27.8% and 68.3%-72.4% respectively. Resistance rates of MRSA and MRCNS to most antimicrobial agents were higher than those of methicillin susceptible strains, vancomycin-, teicoplanin- and linezolid-resistant strains were not found. Resistance rates of Enterococcus faecalis to most tested antimicrobial agents were lower than those of Enterococcus faecium, and both had a few vancomycin-resistant strains. Resistance rate of Streptococcus pneumoniae isolated from non-cerebrospinal fluid specimens to penicillin were 1.0%-2.3%. Resistance rates of Pseu-domonas aeruginosa and Acinetobacter baumannii to imipenem were 10.7%-15.2% and 38.5%-49.4% respectively; resistance rates of Escherichia coli to cefotaxime and imipenem were 48.0%-55.6% and 0.6%-0.8% respectively; resistance rates of Klebsiella pneumoniae to cefotaxime and imipenem were 31.0%-38.3% and 3.9%-6.3% respectively. Resistance rates of Haemophilus influenzae to ampicillin were 37.5%-55.6%. Conclusion Antimicrobial resistance of clinically isolated bacteria from outpatients is still serious, especially carba-penem-resistant Gram-negative bacilli and methicillin-resistant Staphylococcus.
    10  Change in antimicrobial resistance of Granulicatella adiacens isolated from blood specimens, CARSS, 2014-2021
    Hui-min MA ,  Dong-ke CHEN ,  Xiao-yan ZENG ,  Wei CHEN ,  Li-ying SUN ,  Bo ZHENG
    2024, 23(4):415-420. DOI: 10.12138/j.issn.1671-9638.20245421
    [Abstract](64) [HTML](355) [PDF 898.68 K](250)
    Abstract:
    Objective To understand the change in antimicrobial resistance of Granulicatella adiacens (G. adiacens) clinically isolated from blood specimens in China, provide basis for clinical treatment. Methods Surveillance on antimicrobial resistance of bacteria was carried out according to the requirements of China Antimicrobial Resistance Surveillance System (CARSS). Antimicrobial susceptibility testing results of G. adiacens isolated from blood specimens of member units of CARSS in 2014-2021 were analyzed based on standard of American Clinical and Laboratory Standards Institute (CLSI). Results 83-152 strains of G. adiacens were isolated from blood specimens from member units of CARSS each year from 2014 to 2021, there was a gradual increasing trend after 2017. The susceptibility rates of G. adiacens isolated from blood specimens to vancomycin and meropenem were 100% and 93.7% respectively, to ceftriaxone, cefotaxime and cefepime were about 90%, to levofloxacin, penicillin, erythromycin and clindamycin were 82.8%, 65.0%, 32.7% and 46.8%, respectively. From 2014 to 2021, susceptibility rates of G. adiacens to partial antimicrobial agents increased to varying degrees, but to cefepime and meropenem decreased. Conclusion The number of G. adiacens isolated from blood specimens showed a rising trend, G. adiacens exhibits varying degrees of resistance to penicillin, cephalosporins, carbapenems, fluoroquinolones and macrolides, but no vancomycin-resistant strain was found.
    11  Surveillance on antimicrobial resistance of bacteria in different levels of hospitals:surveillance report from China Antimicrobial Resistance Surveillance System in 2014-2019
    China Antimicrobial Resistance Surveillance System
    2021, 20(2):95-111. DOI: 10.12138/j.issn.1671-9638.20216180
    [Abstract](278) [HTML](1139) [PDF 1.21 K](679)
    Abstract:
    Objective To study the bacterial resistance in different levels of hospitals in China from 2014 to 2019. Methods Data related to different levels of hospitals were extracted from reports of China Antimicrobial Resistance Surveillance System (CARSS) in 2014-2019, change in data of tertiary and secondary hospitals were analyzed and compared. Results From 2014 to 2019, the top 5 Gram-positive bacteria isolated from all hospitals were Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis, Streptococcus pneumoniae and Enterococcus faecium. Compared with tertiary hospitals, proportion of Streptococcus pneumoniae in secondary hospitals was higher. The top 5 Gram-negative bacteria from all hospitals were Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii and Enterobacter cloacae. During 6 years, isolation rates of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase negative Staphylococcus (MRCNS) in tertiary hospitals decreased from 36.2% to 30.6% and 79.9% to 76.1% respectively, isolation rates of MRSA and MRCNS in secondary hospitals also decreased. Isolation rate of vancomycin-resistant Enterococcus faecalis in tertiary hospitals was lower than that in secondary hospitals, isolation rates of vancomycin-resistant Enterococcus faecium in tertiary and secondary hospitals all showed a downward trend. Isolation rate of imipenem-resistant Pseudomonas aeruginosa in different levels of hospitals didn't change much, but isolation rates in tertiary hospitals (18.8%-21.4%) were all higher than those in secondary hospitals (12.3%-16.3%) during the same period. Isolation rates of imipenem-resistant Acinetobacter baumannii in different levels of hospitals increased year by year, tertiary hospitals (55.5%-60.2%) were all higher than those in secondary hospitals (38.2%-42.8%) during the same period. Isolation rate of cefotaxime-resistant Escherichia coli in tertiary and secondary hospitals decreased gradually, but tertiary hospitals (51.9%-60.9%) were all higher than those in secondary hospitals (46.7%-56.0%) during the same period. In different levels of hospitals, isolation rate of imipenem-resistant Escherichia coli changed little, all were lower than 2%. In tertiary hospitals, isolation rate of imipenem-resistant Klebsiella pneumoniae increased significantly in different levels of hospitals (from 4.9% to 11.1%), while in secondary hospitals, it increased from 3.6% to 5.3%. Conclusion The proportion of special antimicrobial-resistant bacteria in Gram-positive bacteria in tertiary hospitals has decreased, but change is not obvious in secondary hospitals. Among Gram-negative bacteria, isolation rates of imipenem-resistant Klebsiella pneumoniae and imipenem-resistant Acinetobacter baumannii present a significant upward trend, antimicrobial resistance in tertiary hospitals is more serious than that in secondary hospitals. Management on rational use of antimicrobial agents as well as prevention and control of healthcare-associated infection should be continued to strengthen.
    12  Epidemiological change in carbapenem-resistant Klebsiella pneumoniae:surveillance report from China Antimicrobial Resistance Surveillance in 2014-2019
    China Antimicrobial Resistance Surveillance System
    2021, 20(2):175-179. DOI: 10.12138/j.issn.1671-9638.20216172
    [Abstract](131) [HTML](1732) [PDF 530.00 Byte](561)
    Abstract:
    Objective To investigate the change in antimicrobial resistance of carbapenem-resistant Klebsiella pneumoniae (CRKP) in China. Methods Data of CRKP in report of China Antimicrobial Resistance Surveillance System(CARSS) from 2014 to 2019 were analyzed, change in antimicrobial resistance of CRKP in different areas, different levels of hospitals, different specimen sources, different age groups, and different departments were compared. Results Isolation rate of CRKP in China rose from 6.4% in 2014 to 10.9% in 2019. In 2019, the highest isolation rates of CRKP were in Henan Province and Shanghai City, which were 32.8% and 28.7% respectively, and the lowest rate was 0.6% in Xizang; in 2019, isolation rates of CRKP in children's hospitals, tertiary hospitals and secondary hospitals were 14.0%, 11.6% and 5.5% respectively; isolation rate of CRKP from patients in intensive care unit was the highest (23.0%), which was higher than those of other hospitalized patients, patients in outpatient department and emergency department. Conclusion Isolation rate of CRKP in China is on the rise, there are differences among different area and departments.
    13  Antimicrobial resistance of clinically isolated bacteria from elderly patients:surveillance report from China Antimicrobial Resistance Surveillance System in 2014-2019
    China Antimicrobial Resistance Surveillance System
    2021, 20(2):112-123. DOI: 10.12138/j.issn.1671-9638.20216171
    [Abstract](115) [HTML](670) [PDF 625.00 Byte](432)
    Abstract:
    Objective To analyze the distribution and antimicrobial susceptibility of bacterial strains isolated from elderly patients in China, and provide reference for empirical treatment of infection in elderly patients. Methods In 2014-2019,according to technical program of China Antimicrobial Resistance Surveillance System(CARSS), antimicrobial susceptibility testing was performed by Kirby-Bauer method, automatic instrument method or E-test method, data of pathogenic bacteria from elderly patients (≥ 65 years old) were analyzed by WHONET 5.6 software. Results From 2014 to 2019, the ratio of Gram-positive bacteria to Gram-negative bacteria remained at about 1:4 yearly. Among Gram-positive bacteria, Staphylococcus aureus accounted for 5.9%-6.3%, Enterococcus faecium and Enterococcus faecalis accounted for 3.1%-4.0% and 2.8%-2.9% respectively. Isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) decreased year by year, from 48.8% to 35.2%, isolation rate of methicillin-resistant coagulase negative Staphylococcus (MRCNS) accounted for about 80.0% of coagulase negative Staphy-lococcus, vancomycin- and teicoplanin-resistant strains was not found. Resistance rates of Enterococcus faecalis and Enterococcus faecium to vancomycin decreased from 1.1% to 0.3% and 3.7% to 1.4% respectively. Resistance rate of Streptococcus pneumoniae isolated from non-cerebrospinal fluid specimens to cefotaxime decreased year by year, from 10.0% to 6.1%. The top 4 isolated Gram-negative bacteria were Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii. Resistance rates of Escherichia coli to ceftriaxone and cefotaxime were still higher than 54%, to carbapenems was about 1.3%. Resistance rates of Klebsiella pneumoniae to imipenem and meropenem continued to rise, from 5.6% to 11.7% and 5.2% to 12.1% respectively. Resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii to carbapenems were about 20% and >56% respectively. Except for ceftazidime, resistance rates of Stenotrophomonas maltophilia to other antimicrobial agents decreased significantly in 2015, and then fluctuated slightly, ranging from 0.9% to 1.4%. Resistance rate of Haemophilus influenzae to ampicillin increased continuously, reaching 63.8% in 2019. Conclusion Gram-negative bacteria are the main pathogens causing infection in the elderly, isolation rates of clinically important antimicrobial-resistant bacteria MRSA and vancomycin-resistant Enterococcus continue to decline, while isolation rate of carbapenem-resistant Klebsiella pneumoniae increased persistently, which needs special attention.
    14  Antimicrobial resistance of bacteria from fecal specimens:surveillance report from China Antimicrobial Resistance Surveillance System in 2014-2019
    China Antimicrobial Resistance Surveillance System
    2021, 20(2):168-174. DOI: 10.12138/j.issn.1671-9638.20216175
    [Abstract](71) [HTML](416) [PDF 559.00 Byte](412)
    Abstract:
    Objective To investigate the distribution and antimicrobial resistance of pathogens isolated from fecal specimens in China. Methods Relevant data of fecal specimens (excluding intestinal normal colonized bacteria) were extracted from surveillance report of China Antimicrobial Resistance Surveillance System (CARSS) in 2014-2019, changes of intestinal pathogenic bacteria and antimicrobial resistance rates in the past 6 years were analyzed. Results A total of 61 809 strains were isolated, the top 3 were Salmonella spp. (82.12%), Shigella spp. (8.08%) and Vibrio spp. (4.03%), Salmonella spp. accounted for more than 70% of pathogenic bacteria in fecal specimens each year, with the highest proportion of 87.16% in 2018. In the past 6 years, there was no change in the top 6 pathogenic bacteria strains, only constituent ratios of bacterial species changed slightly each year, Salmonella spp. showed an upward trend, while Shigella spp. showed a downward trend. The major bacteria were unclassified species of Salmonella (49.39%), Shigella flexneri (46.64%), Vibrio parahaemolyticus (91.20%), Aeromonas hydrophila (55.80%) and enteropathogenic Escherichia coli (85.02%). Resistance rate of enteropathogenic bacteria to ampicillin was high, Shigella spp. and diarrheagenic Escherichia coli (>90%) were higher than Salmonella spp. and Vibrio spp. Resistance rate of Salmonella to levofloxacin was low, but show a rising trend, which increased from less than 3% to about 10%; resistance rate of Shigella spp. to ciprofloxacin was low (29.9%) in 2016; resistance rates of Vibrio spp. to antimicrobial agents (except ampicillin) were low (<6%); carbapenem-resistant Aeromonas spp. strains emerged, resistance rates of Aeromonas spp. and diarrheagenic Escherichia coli to amikacin were both low. Conclusion There are multiple species of pathogenic bacteria causing bacterial diarrhea, mainly Salmonella spp. and Shigella spp., antimicrobial resistance is serious, different bacterial species and strains vary significantly, it is necessary to continue to strengthen the management of rational application of antimicrobial agents as well as prevention and control of healthcare -associated infection, and do a good job in the surveillance of antimicrobial-resistant bacteria.
    15  Antimicrobial resistance of bacteria from cerebrospinal fluid specimens: surveillance report from China Antimicrobial Resistance Surveillance System in 2014-2019
    China Antimicrobial Resistance Surveillance System
    2021, 20(1):44-52. DOI: 10.12138/j.issn.1671-9638.20216183
    [Abstract](118) [HTML](662) [PDF 700.00 Byte](699)
    Abstract:
    Objective To investigate the change in distribution and antimicrobial resistance of bacteria isolated from cerebrospinal fluid (CSF) specimens in China. Methods According to China Antimicrobial Resistance Surveillance System(CARSS) technical program, data of bacteria isolated from CSF specimens and antimicrobial susceptibility testing results reported by CARSS member hospitals in 2014-2019 were analyzed with WHONET 5.6 software. Results From 2014 to 2019, a total of 99 741 strains of bacteria were isolated from CSF, the top 5 were coagulase negative Staphylococcus (49 902 strains, 50.0%), Acinetobacter baumannii (7 692 strains, 7.7%), Escherichia coli (5 561 strains, 5.6%), Klebsiella pneumoniae (4 653 strains, 4.7%), and Staphylococcus aureus (4 295 strains, 4.3%). Isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) decreased from 48.2% in 2014 to 39.9% in 2019; isolation rates of penicillin-resistant Streptococcus pneumoniae (PRSP) maintained above 70%; resistance rates of Enterococcus faecium to most tested antimicrobial agents were higher than Enterococcus faecalis; resistance rates of most Escherichia coli strains to ceftriaxone were >60%, to carbapenems were low, but with an upward trend: resistance rates to meropenem and imipenem increased from 2.6% to 4.6% and from 1.7% to 4.5% respectively; resistance rate of Klebsiella pneumoniae to ceftriaxone was>50%, and to carbapenems increased rapidly: resistance rates to meropenem and imipenem increased from 13.1% to 30.9% and from 12.6% to 30.4% respectively. Resistance rates of Acinetobacter baumannii and Pseudomonas aeruginosa to meropenem had decreased tendency, from 74.2% to 71.7% and 32.6% to 27.8% respectively. Conclusion Antimicrobial resistance of clinical isolates of CSF is still high, surveillance on antimicrobial resistance is very important for the effective treatment of central nervous system infection.
    16  Antimicrobial resistance of bacteria isolated from patients in department of urology: surveillance report from China Antimicrobial Resistance Surveillance System, 2021
    全国细菌耐药监测网
    2023(10):1202-1209. DOI: 10.12138/j.issn.1671-9638.20233804
    [Abstract](63) [HTML](225) [PDF 798.72 K](188)
    Abstract:
    Objective To understand the distribution and antimicrobial resistance of bacteria isolated from patients in department of urology in China in 2021. Methods According to the technical program of China Antimicrobial Resistance Surveillance System (CARSS), data and antimicrobial susceptibility testing results of bacteria isolated from patients in department of urology reported by all CARSS member units in 2021were analyzed with WHONET 5.6 software. Results A total of 232 603 strains of bacteria were isolated from urological patients, 166 483 (71.6%) were Gram-negative bacteria and 66 120 (28.4%) were Gram-positive bacteria. The top 5 specimens were urine, blood, wound secretion, sputum, and abdominal peritoneal effusion. The top 5 isolated Gram-negative bacteria were Escherichia coli(57.5%), Klebsiella pneumoniae(10.8%), Pseudomonas aeruginosa(5.8%), Proteus mirabilis(5.3%), and Enterobacter cloacae(3.4%). The top 5 isolated Gram-positive bacteria were Enterococcus faecalis(36.2%), Enterococcus faecium(14.9%), Staphylococcus epidermidis(10.5%), Streptococcus lactis(9.5%), and Staphylococcus aureus(7.3%). Vancomycin-, teicoplanin-, and linezolid-resistant Staphylococcus aureus was not found. The resistance rates of methicillin-resistant Staphylococcus aureus to gentamicin, rifampicin, levofloxacin, cotrimoxazole, clindamycin, and erythromycin were all higher than those of methicillin-sensitive Staphylococcus aureus. The resistance rates of Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis to imipenem(1.1%-5.3%), meropenem(0.7%-5.9%), and ertapenem (0.7%-4.4%) were relatively low, and the resistance rates to ceftriaxone ranged from 36.5% to 54.5%. Resistance rates of Enterobacterales to tegacyclin, polymyxin B, and ceftazidime/avibactam were relatively low. Resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii to imipenem, meropenem, polymyxin B, tegacyclin, ceftazidime/avibactam, and enzyme inhibitor agents were relatively low. Conclusion The major specimen from department of urology is urine, the main isolated pathogenic bacteria are Escherichia coli and Klebsiella pneumoniae, and antimicrobial resistance rate of Enterobacterales is different. Surveillance on the antimicrobial resistance of bacteria isolated from urine specimens can provide reference for the rational use of antimicrobial agents in urinary tract infection.
    17  Change in antimicrobial resistance of pathogens from blood specimens:surveillance report from China Antimicrobial Resistance Surveillance System in 2014-2019
    China Antimicrobial Resistance Surveillance System
    2021, 20(2):124-133. DOI: 10.12138/j.issn.1671-9638.20216173
    [Abstract](141) [HTML](1532) [PDF 671.00 Byte](571)
    Abstract:
    Objective To investigate the distribution and antimicrobial resistance of common clinical pathogens from blood specimens in China. Methods Antimicrobial resistance of bacterial isolates from all blood culture reported on China Antimicrobial Resistance Surveillance System (CARSS) from 2014 to 2019 was analyzed. Results A total of 1 599 273 strains of bacteria were isolated from blood specimens, including 828 846 strains (51.8%) of Gram-negative bacteria. The top 5 pathogens didn't change from 2014 to 2019, the first was Escherichia coli (402 818 strains, 25.2%), followed by Staphylococcus epidermidis (193 968 strains, 12.1%), Klebsiella pneumoniae (162 613 strains, 10.2%), Staphylococcus hominis (136 396 strains, 8.5%) and Staphylococcus aureus (106 915 strains, 6.7%). Among non-fermentative bacteria, Pseudomonas aeruginosa (43 565 strains, 2.7%) and Acinetobacter baumannii (37 244 strains, 2.3%) had the highest isolation rates, but showed a downward trend year by year. Resistance rates of Escherichia coli to carbapenems ranged from 0.8% to 1.6%, and to meropenem increased from 0.8% to 1.3%. Resistance rates of Klebsiella pneumoniae to imipenem and meropenem increased, which were 6.6%-11.7%. Resistance rate of Pseudomonas aeruginosa to imipenem decreased, resistance rate to amikacin decreased from 7.1% to 2.6%. Resistance rate of Acinetobacter baumannii to carbapenems decreased. Vancomycin-, linezolid- and teicoplanin-resistant Staphylococcus spp. was not found. Resistance of Enterococcus to vancomycin, teicoplanin and linezolid were all low. Conclusion Gram-negative bacilli are the most common clinical pathogens from blood specimens in China, there is no significant change in the constituent of species of pathogens. Isolation rate of carbapenem-resistant Klebsiella pneumoniae increased, isolation rates of carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter baumannii decreased, it is necessary to strengthen surveillance on antimicrobial resistance of pathogens causing bloodstream infection and use antimicrobial agents rationally.
    18  Antimicrobial resistance of bacteria from urine specimens: surveillance report from China Antimicrobial Resistance Surveillance System in 2014-2019
    China Antimicrobial Resistance Surveillance System
    2021, 20(1):53-60. DOI: 10.12138/j.issn.1671-9638.20216181
    [Abstract](169) [HTML](747) [PDF 704.00 Byte](610)
    Abstract:
    Objective To investigate the change in distribution and antimicrobial resistance of bacteria isolated from urine specimens in China. Methods According to the technical program of China Antimicrobial Resistance Surveillance System (CARSS), data of bacteria isolated from urine specimens and antimicrobial susceptibility testing results reported by all CARSS member hospitals from 2014 to 2019 were analyzed by WHONET5.6 software. Results The top 5 bacteria isolated from urine specimens of male patients were Escherichia coli (33.1%-34.6%), Enterococcus faecalis (9.2%-10.2%), Klebsiella pneumoniae (9.0%-9.4%), Enterococcus faecium (7.8%-10.2%) and Pseudomonas aeruginosa (5.6%-6.9%), the top 5 bacteria isolated from urine specimens of female patients were Escherichia coli (57.0%-57.4%), Klebsiella pneumoniae (7.5%-8.3%), Enterococcus faecium (6.8%-8.7%), Enterococcus faecalis (5.5%-6.0%) and Proteus mirabilis (3.3%-3.5%). Resis-tance rates of Enterococcus faecalis from urine specimens of male and female patients to ampicillin and nitrofurantoin were <12% and 7% respectively, to vancomycin was <3%; resistance rates of Enterococcus faecium to ampicillin and levofloxacin were both about 90%, to vancomycin were <4%. Resistance rates of Escherichia coli to ceftria-xone were>47%, to cefoperazone/sulbactam, piperacillin/tazobactam, and nitrofurantoin were all ≤8%, resis-tance rate to β-lactams in male patients was higher than in female patients, resistance rate to ceftriaxone was about 12 percentage higher. Resistance rates of Klebsiella pneumoniae isolated from male and female patients to ceftria-xone were about 58% and about 45% respectively. Resistance rates of Pseudomonas aeruginosa isolated from urine specimens of male and female patients to cefoperazone/sulbactam and piperacillin/tazobactam were both <14%, resistance rates to carbapenems were about 15%. Resistance rates of Acinetobacter baumannii to cefoperazone/sulbactam and minocycline were <27% and <22% respectively, resistance rates to carbapenems were 31.7%-47.7% in males and 26.5%-41.2% in females. Conclusion Constituent of bacteria isolated from urine specimens is different in different genders, antimicrobial resistance rates of partial Enterobacteriaceae are different among different genders, resistance rates of partial bacteria also changed in different years. Surveillance on antimicrobial resistance of bacteria isolated from urine specimens can provide reference data for the rational use of antimicrobial agents in urinary tract infection.
    19  Antimicrobial resistance of bacteria isolated from patients in department of oncology: surveillance report from China Antimicrobial Resistance Surveillance System, 2021
    全国细菌耐药监测网
    2023(10):1159-1167. DOI: 10.12138/j.issn.1671-9638.20233802
    [Abstract](70) [HTML](258) [PDF 813.86 K](181)
    Abstract:
    Objective To investigate the distribution and antimicrobial resistance of pathogenic bacteria isolated from infected patients in department of oncology, and provide scientific basis for rational selection of antimicrobial agents in clinical practice. Methods Antimicrobial resistance data of 102 570 bacterial strains from department of on- cology reported by China Antimicrobial Resistance Surveillance System (CARSS) from October 2020 to September 2021 were analyzed with WHONET 5.6. Results The main sources of specimens of patients from department of oncology were sputum (38.3%), urine (18.5%), and blood (12.2%). Among clinically isolated bacteria, the top 3 Gram-positive bacteria were Staphylococcus aureus (35.9%), Enterococcus faecalis (13.6%), and Enterococcus faecium (10.6%). Isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) was 25.0%. Resistance rates of Enterococcus faecalis and Enterococcus faecium to vancomycin were 0.1% and 0.8%, respectively. The top 3 Gram-negative bacteria were Escherichia coli (30.6%), Klebsiella pneumoniae (21.7%), and Pseudomonas aeruginosa (12.0%). Resistance rate of Escherichia coli to third-generation cephalosporins cefotaxime and ceftria-xone exceeded 50%, resistance rate to carbapenems was about 1%. Resistance rate of Klebsiella pneumoniae to carba-penems was about 3%. The isolation rate of carbapenem-resistant Pseudomonas aeruginosa was about 6%. Conclusion Gram-negative bacteria are the major clinically isolated bacteria from tumor patients, resistance rate of which is not high. Rational use of antimicrobial agents should be strengthened in clinical practice, and monitoring on bacterial resistance should be conducted well.
    20  Multidrug-resistant organisms in traditional Chinese medicine hospitals: surveillance report from China Antimicrobial Resistance Surveillance System, 2018-2021
    全国细菌耐药监测网
    2023(10):1148-1158. DOI: 10.12138/j.issn.1671-9638.20233800
    [Abstract](154) [HTML](668) [PDF 831.84 K](252)
    Abstract:
    Objective To understand the distribution and changing trend of multidrug-resistant organisms (MDROs) from clinical specimens in traditional Chinese medicine hospitals, provide scientific basis for rational clinical antimicrobial use. Methods In vitro antimicrobial susceptibility testing data of frequently clinically isolated bacteria from traditional Chinese medicine hospitals nationwide from 2018 to 2021 were collected. In vitro antimicrobial susceptibility testing methods included disk diffusion method, automated apparatus method, and E-test method. Antimicrobial susceptibility testing results were interpreted according to the American Clinical and Laboratory Standards Institute (CLSI) standards. According to the technical program of China Antimicrobial Resistance Surveillance System (CARSS), the distribution of bacterial species as well as the detection and changing trend of MDROs were analyzed with WHONET 5.6 software. Results Among clinical isolates from 2018 to 2021, Gram-positive and Gram-negative bacteria accounted for 26.4%-27.4% and 72.6%-73.6%, respectively, with a stable trend. Among Gram-positive bacteria, isolation rates of methicillin-resistant Staphylococcus aureus (MRSA) increased from 28.5% to 30.2%, however, methicillin-resistant coagulase negative Staphylococcus (MRCNS), vancomycin-resistant Enterococcus faecium and penicillin-resistant Streptococcus pneumoniae (PRSP) all showed decreasing trends, from 76.1%, 2.7% and 3.1% in 2018 to 72.4%, 1.5% and 1.8%, respectively. Among Gram-negative bacteria, isolation rates of carbapenem-resistant Escherichia coli and carbapenem-resistant Klebsiella pneumoniae gradually increased from 1.6% and 10.4% to 1.9% and 13.3%, respectively. However, isolation rates of carbapenem-resistant Pseudomonas aeruginosa and carbapenem-resistant Acinetobacter baumannii showed downward trends, decreasing from 22.4% and 49.5% to 21.9% and 48.2%, respectively. In addition, detection of MDROs varied significantly in different regions. Isolation rates of MRSA were highest in Anhui, Jiangsu, and Guangdong Provinces, but lowest in Yunnan, Heilongjiang, and Jilin Provinces. Meanwhile, isolation rates of carbapenem-resistant Klebsiella pneumoniae were highest in Anhui Province, Shanghai City, and Henan Province, but lowest in Ningxia, Qinghai and Jilin Provinces. Conclusion The isolation rates of MRSA, carbapenem-resistant Klebsiella pneumoniae, and carbapenem-resistant Escherichia coli show increasing trends, while isolation rates of other clinically isolated MDROs present downward trends or remain unchanged. There are temporal and regional differences in the isolation rate of MDROs. Management of rational use of antimicrobial agents as well as healthcare-associated infection prevention and control should continue to be strengthened, bacterial antimicrobial resistance monitoring should be conducted well.
    21  Antimicrobial resistance of bacteria isolated from patients in department of hematology: surveillance report from China Antimicrobial Resistance Surveillance System, 2021
    全国细菌耐药监测网
    2023(10):1168-1176. DOI: 10.12138/j.issn.1671-9638.20233806
    [Abstract](83) [HTML](681) [PDF 807.46 K](213)
    Abstract:
    Objective To understand the distribution and antimicrobial resistance of bacteria isolated from patients in department of hematology in China, and provide scientific basis for rational clinical antimicrobial use in patients with infection from department of hematology. Methods According to the technical program from China Antimicrobial Resistance Surveillance System (CARSS), distribution and antimicrobial resistance of clinically isolated bacteria from patients in department of hematology in 2021 were analyzed by WHONET 5.6 software. Results A total of 74 300 non-repetitive clinically isolated strains were collected from patients from department of hematology in CARSS hospitals, including 53 970 (72.6%) Gram-negative bacteria and 20 330 (27.4%) Gram-positive bacteria. Escherichia coli was the most frequently isolated bacteria (n=16 051, 21.6%), followed by Klebsiella pneumoniae (11 214, 15.1%), Pseudomonas aeruginosa (6 071, 8.2%), Staphylococcus aureus (4 768, 6.4%) and Enterococcus faecium (3 600, 4.8%). The most common specimen source was blood (24.6%), followed by sputum (24.0%) and urine (16.6%). The resistance rates of Escherichia coli to imipenem and meropenem were 4.4% and 4.3%, respectively, and those of Klebsiella pneumoniae to imipenem and meropenem were 10.8% and 11.5%, respectively. Resistance rates of Pseudomonas aeruginosa to imipenem and meropenem were 16.7% and 12.8%, respectively. Resistance rates of Acinetobacter baumannii to most tested antimicrobial agents were 14.3%-27.0%, except polymyxin B, minocycline and tigecycline, which were less than 10%. The resistance rate of Haemophilus influenzae to ampicillin was 64.5%. Among Staphylococcus aureus and coagulase negative Staphylococcus, isolation rates of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase negative Staphylococcus (MRCNS) were 28.8% and 82.1%, respectively. No Staphylococcus aureus strains were found to be resistant to vancomycin and linezolid. The resistance rates of Enterococcus faecium and Enterococcus faecalis to vancomycin were 3.2% and 0.2%, respectively, and that of Streptococcus pneumoniae to penicillin was 1.6%. No Streptococcus strains were found to be resistant to vancomycin and linezolid. Conclusion Gram-negative bacteria are the major bacteria isolated from department of hematology. Carbapenem-resistant Klebsiella pneumoniae, linezolid-resistant Staphylococcus and linezolid-resistant Enterococcus should be paid more attention. Monitoring of antimicrobial resistance of pathogenic bacteria should be strengthened, and antimicrobial agents should be used rationally.
    22  Antimicrobial resistance of bacteria isolated from patients in department of nephrology: surveillance report from China Antimicrobial Resistance Surveillance System, 2021
    全国细菌耐药监测网
    2023(10):1185-1192. DOI: 10.12138/j.issn.1671-9638.20233805
    [Abstract](72) [HTML](175) [PDF 833.52 K](171)
    Abstract:
    Objective To understand the distribution and antimicrobial resistance of frequently isolated pathogenic bacteria from hospitalized patients in nephrology department in China. Methods All isolated pathogenic bacteria from hospitalized patients in nephrology department reported by member units of China Antimicrobial Resistance Surveillance System (CARSS) in 2021 and their antimicrobial resistance were analyzed. Results A total of 122 203 bacterial strains were isolated from hospitalized patients in nephrology department, mainly from urine, sputum and blood, accounting for 49.2%, 16.7% and 13.4%, respectively. 81 994 strains (67.1%) were Gram-negative bacteria and 40 209 strains (32.9%) were Gram-positive bacteria. The top 5 frequently isolated pathogens were Escherichia coli (39 914, 32.7%), Klebsiella pneumoniae (12 695, 10.4%), Staphylococcus aureus (11 977, 9.8%), Pseudomonas aeruginosa (6 583, 5.4%) and Enterococcus faecium (5 821, 4.8%). The detection rate of ceftria-xone-resistant Escherichia coli and Klebsiella pneumoniae were 47.2% (15 704/33 272) and 30.7% (3 091/10 070), respectively. The detection rates of carbapenem-resistant Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae were 1.0% (388/38 813), 8.2% (1 000/12 206) and 4.8% (135/2 813), respectively. The resistance rates of Acinetobacter baumannii to imipenem, meropenem, polymyxin and tigecycline were 27.6% (972/3 523), 29.6% (813/2 748), 1.3% (8/625) and 2.2% (38/1 730), respectively. The resistance rates of Pseudomonas aeruginosa to imipenem, meropenem and polymyxin were 10.1% (640/6 335), 8.4% (477/5 678) and 1.2% (11/955), respectively. The detection rates of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcs (MRCNS) were 23.3% (2 787/11 977) and 68.5% (7 290/10 644), respectively. No vancomycin-resistant Staphylococcus was detected. The resistance rates of Enterococcus faecium and Enterococcus faecalis to vancomycin were 1.1% (65/5 740) and 0.1% (7/4 738), respectively. Conclusion Gram-negative bacteria isolated from hospitalized patients in nephrology department are mainly Escherichia coli and Klebsiella pneumoniae, and Gram-positive bacteria are mainly Staphylococcus aureus. The resistance rates of Gram-ne-gative bacteria to carbapenems, piperacillin/tazobactam, cefoperazone/sulbactam, and ceftazidime/avibactam are low, and the resistance rates of Gram-positive bacteria to vancomycin, teicoplanin, and linezolid are low. Antimicrobial agents should be selected rationally according to antimicrobial susceptibility testing results and disease features of patients in nephrology department.
    23  Antimicrobial resistance of bacteria from pleural effusion specimens:surveillance report from China Antimicrobial Resistance Surveillance System in 2014-2019
    China Antimicrobial Resistance Surveillance System
    2021, 20(2):157-167. DOI: 10.12138/j.issn.1671-9638.20216186
    [Abstract](72) [HTML](413) [PDF 794.00 Byte](370)
    Abstract:
    Objective To investigate the distribution characteristics and antimicrobial resistance of pathogens isolated from pleural effusion specimens in China. Methods According to China Antimicrobial Resistance Surveillance System (CARSS) technical program, data of bacteria isolated from pleural effusion specimens and antimicrobial susceptibility testing results reported by CARSS member hospitals in 2014-2019 were analyzed with WHONET 5.6 software. Results A total of 75 375 strains of bacteria were isolated from pleural effusion specimens in 2014-2019, Gram-positive bacteria were mainly Staphylococcus aureus; Gram-negative bacteria were mainly Escherichia coli and Klebsiella pneumoniae. Isolation rates of methicillin-resistant Staphylococcus aureus (MRSA) in 6 years were between 33.7%-43.4%. Resistance rates of MRSA to all antimicrobial agents were all significantly higher than those of methicillin-susceptible Staphylococcus aureus (MSSA). Vancomycin-, teicoplanin- and linezolid-resistant Staphylococcus aureus were not found; resistance rates of Streptococcus pneumoniae to penicillin were 1.1%-7.6%; most Enterobacteriales had good activity on carbapenems, resistance rates of Escherichia coli to the third generation cephalosporins showed a slightly downward trend. Conclusion Isolation rate and distribution of bacteria from pleural effusion in China changed little, proportion of Gram-positive bacteria and Gram-negative bacteria is similar. Resistance rates of some strains to partial antimicrobial agents decreased in varying degrees. Surveillance on Staphylococcus aureus, Escherichia coli and Klebsiella pneumoniae should be strengthened to guide clinical rational antimicrobial use.

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