title: Epidemiology and characteristics of antimicrobial resistance in China.
abstract: A comprehensive surveillance system for bacterial resistance in tertiary hospitals has been established in China that involves tertiary hospitals in distinct regions nationwide, enabling the collection of a large amount of antimicrobial surveillance data. Antimicrobial resistance in China has become a serious healthcare problem, with high resistance rates of most common bacteria to clinically important antimicrobial agents. Methicillin-resistant S. aureus, ESBL-producing Enterobacteriaceae and carbapenem-resistant Acinetobacter baumannii represent more than 50% of microbial isolates. Additionally, bacterial resistance to fluoroquinolones, macrolides and third-generation cephalosporins is of serious concern. The molecular epidemiology and resistance mechanisms of the antimicrobial strains in China exhibited regional specificity, as well as the influence of dissemination of international clonal complexes. The molecular characteristics of MRSA, ESBL- and carbapenemase-producing Enterobacteriaceae, and macrolide-resistant gram-positive Streptococci in China were significantly different from those in other countries and regions, while S. pneumoniae serotypes appear to have been affected by the global spread of prevalent clones in other parts of the world. Moreover, important antimicrobial resistant bacteria such as community-acquired-MRSA, multidrug-resistant P. aeruginosa and extensive-resistant A. baumannii, and the antimicrobial resistance in primary healthcare and outpatient setting should be intensely monitored and investigated in the future.
authors.affiliation: State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China. xiao-yonghong@163.com
authors.forename: Yong-Hong
authors.initials: YH
authors.lastname: Xiao
authors.forename: Christian G
authors.initials: CG
authors.lastname: Giske
authors.forename: Ze-Qing
authors.initials: ZQ
authors.lastname: Wei
authors.forename: Ping
authors.initials: P
authors.lastname: Shen
authors.forename: Andreas
authors.initials: A
authors.lastname: Heddini
authors.forename: Lan-Juan
authors.initials: LJ
authors.lastname: Li
mesh_terms: D000900:Anti-Bacterial Agents / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology*; D002681:China / Q000453:epidemiology; D024881:Drug Resistance, Bacterial / Q000502:physiology*; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics / Q000502:physiology; D006801:Humans; D008826:Microbial Sensitivity Tests; D017891:Pharmacoepidemiology
chemical_list: D000900:Anti-Bacterial Agents