[Surveillance of antimicrobial resistance among nosocomial gram-negative pathogens from 15 teaching hospitals in China in 2005].
OBJECTIVE
To investigate the antimicrobial resistance among the nosocomial gram-negative pathogens from 15 teaching hospitals located in different areas in China in 2005.


METHODS
A total of 1927 non-repetitive nosocomial gram-negative pathogens were collected from 15 teaching hospitals in different areas in China and sent to the central lab for reidentification and susceptibility testing. The levels of minimal inhibitory concentration (MIC) of 18 antimicrobial agents were determined by agar dilution method. WHONET 5.4 software was used to analyze the data.


RESULTS
The strains of Escherichia coli, Klebsiella pneumoniae, and Proteous mirabilis isolates that did not produce extended spectrum beta lactamases (ESBLs) showed high sensitivity to beta-lactams. The antibiotics with a susceptibility rates over 80% against the strains of Entorobacter cloacae, Enterobacter aerogene, Citrobacter spp, Serratia spp, and Proteous vulgaris producing AmpC enzyme included meropenem, imipenem, and piperacillin-tazobactam, and these 3 drugs showed a susceptibility rate of more than 80% against the ESBL-producing strains of Escherichia coli and Klebsiella pneumoniae. Other antimicrobial agents showing a relatively high activity against Enterobacter spp, Citrobacter spp, Serratia spp and Proteous vulgaris included cefepime (67.3% - 100%), amikacin (67.3% - 95.2%), ceftazidime (52.9% - 100%) and cefoperazone-sulbactam (51.9% - 100%). The susceptibility rate of fluoroquinolones was 34.8% - 36.1% against non-ESBL-producing Escherichia coli and was 13.4% - 17.1% against ESBL-producing isolates. The most active agent against Pseudomonas aeruginosa was polymyxin B (95.6%). The agents with the activity rates of 70% - 80% included meropenem, imipenem, amikacin, and piperacillin-tazobactam. The antibiotic with a high susceptible rate against Acinetobacter baumannii was polymyxin B (98.3%), followed by imipenem (80.8%), meropenem (76.2%), and minocycline (67.4%). The susceptible rates of other agents were all below 60%. The agents with relatively high activity against Stenotrophomonas maltophilia included minocycline (85%), levofloxacin (82.5%), and trimethoprim-sulfamethoxazole (77.5%). The agents with a relatively high activity against Burkholderia cepacia included minocycline (77.2%) and meropenem (61.4%).


CONCLUSIONS
Carbapenem, piperacillin-tazobactam, amikacin and cefepime remained relatively high activity against nosocomial Enterobacteriaceae, Non-fermenting pathogens have lower susceptibility to the antimicrobial agents than before.
Yang
Qi-wen
QW
Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China.
Xu
Ying-chun
YC
Chen
Min-jun
MJ
Hu
Yun-jian
YJ
Ni
Yu-xing
YX
Sun
Jing-yong
JY
Yu
Yun-song
YS
Kong
Hai-shen
HS
He
Lin
L
Wu
Wei-yuan
WY
Ye
Hui-fen
HF
Yang
Yin-mei
YM
Zhu
Lian-na
LN
Guo
Shi-hui
SH
Ji
Ping
P
Zhu
Zhen-hong
ZH
Ren
Jian-kang
JK
Zhang
Li-xia
LX
Sun
Zi-yong
ZY
Zhu
Xu-hui
XH
Tong
Ming-qing
MQ
Zhao
Wang-sheng
WS
Mei
Ya-ning
YN
Liu
Yong
Y
Zhang
Zhi-jie
ZJ
Duan
Qiong
Q
Li
Dan
D
Liu
Peng-peng
PP
Wang
Jing
J
Han
Li-xia
LX
Wang
Hui
H
Xie
Xiu-li
XL
D000150:Acinetobacter / Q000187:drug effects / Q000302:isolation & purification; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002681:China; D003428:Cross Infection / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D004754:Enterobacter / Q000187:drug effects / Q000302:isolation & purification; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000302:isolation & purification*; D006784:Hospitals, Teaching; D006801:Humans; D008826:Microbial Sensitivity Tests; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000302:isolation & purification
D000900:Anti-Bacterial Agents