title: Antimicrobial susceptibility of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis isolated from community-acquired respiratory tract infections in China: Results from the CARTIPS Antimicrobial Surveillance Program.
abstract: This study investigated the antimicrobial susceptibilities of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis isolates causing adult community-acquired respiratory tract infections (CARTIs) in China. A multicentre resistance surveillance study (CARTIPS) investigating 1046 clinical isolates from 19 hospitals in China was conducted from 2013 to 2014. Based on the minimum inhibitory concentration (MIC) breakpoints of oral penicillin, the percentages of penicillin-resistant, penicillin-intermediate and penicillin-susceptible S. pneumoniae were 44.1%, 13.7%, and 42.2%, respectively. The rates of penicillin-non-susceptible S. pneumoniae ranged from 27.9% to 72.2% in different cities, with the highest rate in Nanchang. Macrolides, including azithromycin, clarithromycin and erythromycin, showed the lowest activities against S. pneumoniae isolates, with resistance rates of 90.5%, 92.2% and 93.0%, respectively. However, 98% of these strains were susceptible to levofloxacin and moxifloxacin. For H. influenzae isolates, most of the antimicrobials agents exhibited good activities. However, ampicillin and trimethoprim/sulfamethoxazole showed relatively lower activity against H. influenzae, with resistance rates of 35.0% and 54.4%, respectively. β-lactamase production rates amongst H. influenzae and M. catarrhalis were 31.0% and 87.1%, respectively. In addition, a total of 15 β-lactamase-negative ampicillin-resistant (BLNAR) strains identified in this study were resistant to ampicillin, amoxicillin/clavulanic acid, cefaclor and cefuroxime. Most of the antimicrobial agents showed excellent activity against M. catarrhalis, with susceptibility rates of >90%. The results from the current study confirmed the regional variations in antimicrobial susceptibility of major CARTI pathogens and provided some choices for the treatment of these organisms. Continuous national surveillance of the epidemiology of CARTIs is strongly warranted in China.
authors.affiliation: Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China.
authors.forename: Yawei
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China.
authors.forename: Feifei
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China. Electronic address: wanghui@pkuph.edu.cn.
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China.
authors.forename: Chunjiang
authors.initials: C
authors.lastname: Zhao
authors.affiliation: Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China.
authors.forename: Zhanwei
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Cao
authors.affiliation: Department of Clinical Laboratory, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Du
authors.affiliation: Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Xianju
authors.initials: X
authors.lastname: Feng
authors.affiliation: Department of Clinical Laboratory, Beijing Hospital, Beijing, China.
authors.forename: Yunjian
authors.initials: Y
authors.lastname: Hu
authors.affiliation: Department of Infectious Diseases, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Bijie
authors.initials: B
authors.lastname: Hu
authors.affiliation: Department of Clinical Laboratory, The First Teaching Hospital of Xinjiang Medical University, Urumqi, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Ji
authors.affiliation: Department of Clinical Laboratory, Southwest Hospital, Chongqing, China.
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Clinical Laboratory, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Clinical Laboratory, The First Affiliated Hospital of Nanchang University, Nanchang, China.
authors.forename: Wanzhen
authors.initials: W
authors.lastname: Liao
authors.affiliation: Department of Clinical Laboratory, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Lu
authors.affiliation: Department of Clinical Laboratory, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Hongli
authors.initials: H
authors.lastname: Sun
authors.affiliation: Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
authors.forename: Zhongxin
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Clinical Laboratory, Xijing Hospital, Xi'an, China.
authors.forename: Xiuli
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Clinical Laboratory, China-Japan Union Hospital of Jilin University, Jilin, China.
authors.forename: Xuesong
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Clinical Laboratory, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Yang
authors.affiliation: Department of Infectious Diseases, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Yunsong
authors.initials: Y
authors.lastname: Yu
authors.affiliation: Department of Clinical Laboratory, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Zhang
authors.affiliation: Department of Infectious Diseases, Guangzhou Institute of Respiratory Disease, Guangzhou, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Zhuo
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002681:China; D024881:Drug Resistance, Bacterial; D006193:Haemophilus influenzae / Q000187:drug effects*; D006801:Humans; D001936:Moraxella catarrhalis / Q000187:drug effects*; D012141:Respiratory Tract Infections / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000187:drug effects*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antimicrobial resistance; Community-acquired respiratory tract infection; Surveillance