title: [Analysis of pathogen spectrum and resistance of clinical common organisms causing bloodstream infections, hospital-acquired pneumonia and intra-abdominal infections from thirteen teaching hospitals in 2013].
abstract: OBJECTIVE
  To investigate the spectrum and antimicrobial resistance of major pathogensthat causing nosocomial infections in China, 2013.
  
  
  METHODS
  Nosocomial cases as well as pathogens causing bloodstream infections (BSI), hospital-acquired pneumonia (HAP) and intra-abdominal infections (IAI) from 13 teaching hospital around China were collected. The minimum inhibitory concentrations (MICs) were determined by the agar dilution method. The CLSI M100-S23 criteria were used for interpretation.
  
  
  RESULTS
  Of all cases, 1 022 cases were from BSI, 683 from HAP and 674 from IAI.Escherichia coli and Klebsiella pneumoniae were the most prevalent pathogens causing BSI and IAI while Acinetobacter baumanii (34.6%) and Pseudomonas aeruginosa were dominated in HAP. Tigecycline, imipenem and meropenem exhibited high potency against Enterobacteriaceae and the susceptibilities rates were 95.6%, 94.2%and 95.2% respectively. Enterobacteriaceae demonstrated high resistance against cephalosporins (52.3%) and fluoroquinolones (38.9%) but were susceptible to β-lactam+inhibitor. Of all the Enterobacteriaceae, 30.5% were ESBLs positive and 4.3% were carbapenem resistant. Acinetobacter baumanii showed low susceptibilities to the microbial agents except for tigecycline (90.5%) and colistin (100%). The rate of carbapenem resistant Acinetobacter baumanii was 76.6%. Amikacin, ciprofloxacin, cefepime and piperacillin/tazobactam showed high antibacterial activity against Pseudomonas aeruginosa with susceptible rate 88.5%, 77.6%, 72.7% and 64.5% respectively. The resistant rate to imipenem and meropenem were 42.1% and 32.2%. All Staphylococcus aureus (166 strains) were susceptible to tigecycline, linezolid, daptomycin and glycopeptides. MRSA accounted for 46.9% of all the Staphylococcus aureus. The prevalence of MRSA in IAI (55.2%) and HAP (54.4%) were higher that that in BSI (35.0%). No Enterococcus strains were found resistant to tigecycline, linezolid and daptomycin. VRE was found in Enterococcus faecium, accounting for 1.9% of all Enterococcus faecium strains.
  
  
  CONCLUSIONS
  Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa are the most common pathogens causing nosocomial infections. Nosocomial pathogens showed high susceptibilities against tigecycline. For ESBLs-producing Enterobacteriaceae strains, β-lactam+Inhibitor show high antibacterial activities. Vancomycin, teicoplanin and linezolid exhibit high potency to Staphylococcus aureus and Enterococcus.
authors.affiliation: Department of Laboratory Medicine, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Chunjiang
authors.initials: C
authors.lastname: Zhao
authors.forename: Hongbin
authors.initials: H
authors.lastname: Chen
authors.affiliation: Email: whuibj@163.com.
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
authors.forename: Wenen
authors.initials: W
authors.lastname: Liu
authors.forename: Chao
authors.initials: C
authors.lastname: Zhuo
authors.forename: Yunzhuo
authors.initials: Y
authors.lastname: Chu
authors.forename: Ji
authors.initials: J
authors.lastname: Zeng
authors.forename: Yan
authors.initials: Y
authors.lastname: Jin
authors.forename: Zhidong
authors.initials: Z
authors.lastname: Hu
authors.forename: Rong
authors.initials: R
authors.lastname: Zhang
authors.forename: Bin
authors.initials: B
authors.lastname: Cao
authors.forename: Kang
authors.initials: K
authors.lastname: Liao
authors.forename: Bijie
authors.initials: B
authors.lastname: Hu
authors.forename: Xiuli
authors.initials: X
authors.lastname: Xu
authors.forename: Yanping
authors.initials: Y
authors.lastname: Luo
authors.forename: Mingxiang
authors.initials: M
authors.lastname: Zou
authors.forename: Danhong
authors.initials: D
authors.lastname: Su
authors.forename: Yong
authors.initials: Y
authors.lastname: Wang
authors.forename: Bin
authors.initials: B
authors.lastname: Tian
authors.forename: Hongwei
authors.initials: H
authors.lastname: Zhou
authors.forename: Yingmei
authors.initials: Y
authors.lastname: Liu
authors.forename: Penghao
authors.initials: P
authors.lastname: Guo
authors.forename: Chunmei
authors.initials: C
authors.lastname: Zhou
authors.forename: Xiao
authors.initials: X
authors.lastname: Chen
authors.forename: Zhanwei
authors.initials: Z
authors.lastname: Wang
authors.forename: Feifei
authors.initials: F
authors.lastname: Zhang
mesh_terms: D000900:Anti-Bacterial Agents; D016470:Bacteremia; D015780:Carbapenems; D000077723:Cefepime; D002511:Cephalosporins; D002681:China; D003428:Cross Infection; D006784:Hospitals, Teaching; D006801:Humans; D059413:Intraabdominal Infections; D008826:Microbial Sensitivity Tests; D008911:Minocycline / Q000031:analogs & derivatives; D011014:Pneumonia; D000078304:Tigecycline; D014640:Vancomycin
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D002511:Cephalosporins; D014640:Vancomycin; D000078304:Tigecycline; D000077723:Cefepime; D008911:Minocycline