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Chinese Journal of Evidence -Based Pediatric ›› 2019, Vol. 14 ›› Issue (5): 321-326.DOI: 10.3969/j.issn.1673-5501.2019.05.001

• Original Papers •     Next Articles

Antimicrobial resistance profile of clinical isolates in pediatric hospitals in China: report from the ISPED Surveillance Program, 2018

FU pan1, WANG Chuan-qing1, YU Hui2, XU Hong-mei3, JING Chun-mei4, DENG Ji-kui5, ZHAO Rui-zhen6, HUA Chun-zhen7, CHEN Ying-hu7, CHEN Xue-jun8, ZHANG Ting9, ZHANG Hong10, CHEN Yi-ping11, YANG Jin-hong12, LIN Ai-wei13, WANG Shi-fu14, CAO Qing15, WANG Xing16, DENG Hui-ling17, CAO San-cheng18, HAO Jian-hua19, GAO Wei20, HUANG Yuan-yuan21   

  1. Children's Hospital of Fudan University (Shanghai,201102) 1 Microbiology department of Clinical Medical Laboratory; 2 Infectious Disease Department;
    Children's Hospital of Chongqing Medical University (Chongqing, 400014) 3 Infectious Disease Department; 4 Department of Medical Laboratory;
    Shenzhen Children's Hospital (Shenzhen, 518038) 5 Infectious Disease Department; 6 Department of Medical Laboratory;
    The Children's Hospital Zhejiang University School of Medicine (Hangzhou, 310003) 7 Infectious Disease Department; 8 Department of Medical Laboratory;
    Children's Hospital of Shanghai Jiaotong University (Shanghai, 200040) 9 Digestive and Infectious Disease Department; 10 Department of Medical Laboratory;
    Yuying Children's Hospital of Wenzhou Medical University (Wenzhou, 325027) 11 Infectious Disease Department; 12 Department of Medical Laboratory;
    Qilu Children's Hospital of Shandong University (Jinan,250022) 13 Infectious Disease Department; 14 Department of Medical Laboratory;
    Shanghai Children's Medical Center (Shanghai, 200127) 15 Infectious Disease Department; 16 Department of Medical Laboratory;
    Xi'an Children's Hospital (Xi'an, 710043) 17 Infectious Disease Department; 18 Department of Medical Laboratory;
    Children's Hospital of Kaifeng City (Kaifeng, 475099) 19 Infectious Disease Department; 20 Department of Medical Laboratory;
    The First Hospital Affiliated to Jiling University (Changchun, 130021) 21 Pediatric Department
  • Received:2019-10-15 Online:2019-10-25
  • Contact: WANG Chuan-qing, E-mail:chuanqing523@163.com; YU Hui,E-mail:yuhui4756@sina.com

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Abstract: Objective This study is aimed to investigate the antimicrobial resistance profiles of pathogens in Chinese children.Methods Clinical isolates were collected from 11 tertiary children hospitals in China in 2018. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems interpreted according to the criteria of Clinical and Laboratory Standards Institute (CLSI) 2017 breakpoints. Penicillin susceptibility of streptococcus pneumonia was detected by E-test.Results A total of 62,212 isolates were collected, of which 42.2% was gram-positive organisms and 57.8% was gram-negative organisms. Top-five pathogens were as follows, Streptococcus pneumonia (12.9%), Escherichia coli (12.4%), Haemophilus influenza (11.8%), Straphylococcus aureus (10.3%), and Moraxella catarrhalis (7.2%). In neonatal group, Straphylococcus aureus was the primary pathogen (17.0%). More than half of pathogens (57.0%) were seperated from respiratory tract, Streptococcus pneumonia and Streptococcus pyogenes were the primary pathogens isolated in lower and upper respiratory tract respectively. Carbapenem resistance Enterobacteriaceae(CRE) accounted for 8.7%. The detection rate of CRE in neonatal group was 16.8%, much higher than that in non-neonatal group (7.2%). CRE strains represented high-level resistances to many antibiotics. Carbapenem resistant Acinetobacter baumannii (CR-ab) was 63.2% in total and the rate in neonatal group was 35.2%, much lower than than in non-neonatal group (69.7%). Carbapenem resistant Pseudomonas aeruginosa (CR-pae) was 27.2% and showed no difference between neonatal (25.0%) and non-neonatal (27.3%) groups. The Methicillin-resistant Staphylococcus aureus (MRSA) and Coagulase negative staphylococci (MRCNS) were 34.9% and 77.3% respectively. We detected 0.1% penicillin non-susceptible β-hemolytic Streptococcus pyogenes. The penicillin non-susceptible rates of Streptococcus pneumonia (PNSP) from non-cerebrospinal fluid was 21.3%. The β-lactamase positive rate of Haemophilus pneumonia isolates was increased to 61.1%.Conclusion Respiratory infection was the most common pediatric infections. Carbapenem-resistant bacteria presented high-level resistance to various antibiotics. In neonatal group, CRE was higher than that in non-neonatal group but CR-ab was lower than that in non-neonatal group.

Key words: 2018, Antimicrobials resistance, Bacteria, Children, ISPED