State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.
Drug Resist Updat. 2011 Aug-Oct;14(4-5):236-50. doi: 10.1016/j.drup.2011.07.001. Epub 2011 Jul 31.
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.
中国已经建立了一个涵盖全国不同地区三级医院的细菌耐药性全面监测系统，能够收集大量抗菌药物监测数据。中国的抗菌药物耐药性已成为一个严重的医疗保健问题，大多数常见细菌对临床重要抗菌药物的耐药率很高。耐甲氧西林金黄色葡萄球菌、产超广谱β-内酰胺酶肠杆菌科和碳青霉烯类耐药鲍曼不动杆菌的检出率超过 50%。此外，细菌对氟喹诺酮类、大环内酯类和第三代头孢菌素的耐药性也令人严重关切。中国抗菌药物耐药菌株的分子流行病学和耐药机制具有地域特异性，同时也受到国际克隆复合体传播的影响。中国耐甲氧西林金黄色葡萄球菌、产超广谱β-内酰胺酶和碳青霉烯酶肠杆菌科以及大环内酯类耐药阳性链球菌的分子特征与其他国家和地区明显不同，而肺炎链球菌血清型似乎受到世界其他地区流行克隆传播的影响。此外，未来应加强对社区获得性耐甲氧西林金黄色葡萄球菌、多药耐药铜绿假单胞菌和广泛耐药鲍曼不动杆菌等重要耐药菌以及基层医疗机构和门诊抗菌药物耐药性的监测和研究。
