Department of Clinical Laboratory, Peking Union Medical College Hospital, Beijing, China.
Int J Antimicrob Agents. 2011 Nov;38(5):376-83. doi: 10.1016/j.ijantimicag.2011.06.015. Epub 2011 Aug 30.
A multicentre resistance surveillance study [Community-Acquired Respiratory Tract Infection Pathogen Surveillance (CARTIPS)] investigating the susceptibilities of 2963 clinical isolates of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Klebsiella pneumoniae, meticillin-susceptible Staphylococcus aureus (MSSA) and Streptococcus spp. from Asia against 12 antimicrobial agents was undertaken from 2009 to 2010. Based on the breakpoints for oral penicillin V recommended by the Clinical and Laboratory Standards Institute, the prevalence of penicillin-non-susceptible S. pneumoniae (PNSSP) ranged from 46% to 100%. Azithromycin and clarithromycin exhibited variable resistance rates of 0-88% against S. pneumoniae, 0-57% against MSSA and 0-76.5% against Streptococcus spp. isolates. The prevalence of extended-spectrum β-lactamase-producing K. pneumoniae varied from 5.1% to 58.5%. β-Lactamase production rates amongst H. influenzae isolates ranged from 15% to 46.6% and amongst M. catarrhalis isolates from 90% to 100%. Amongst M. catarrhalis isolates, macrolide resistance and cefaclor resistance rates of 5.8% and 1.2%, respectively, were found, mainly in Mainland China. Levofloxacin resistance rates of 0-3.9% with a MIC(90) (minimum inhibitory concentration causing inhibition of 90% of isolates) of 1-2mg/L and moxifloxacin resistance rates of 0-1.7% with a MIC(90) of 0.125-0.5mg/L were found amongst PNSSP isolates. Moxifloxacin was very active against Streptococcus spp., H. influenzae and M. catarrhalis isolates, with MIC(90) values of 0.125-0.25, 0.032-0.5 and 0.064-0.125mg/L, respectively. These results from the CARTIPS study have confirmed some significant regional differences in the antimicrobial susceptibilities of S. pneumoniae, MSSA, K. pneumoniae, H. influenzae and Streptococcus spp. and emphasise the importance of antimicrobial surveillance programmes for guiding empirical therapy and for focusing interventional control of antimicrobial resistance in distinct geographic areas.
一项针对亚洲地区 2963 株临床分离肺炎链球菌、流感嗜血杆菌、卡他莫拉菌、肺炎克雷伯菌、甲氧西林敏感金黄色葡萄球菌（MSSA）和链球菌的 12 种抗菌药物药敏的多中心耐药监测研究[社区获得性呼吸道感染病原体监测（CARTIPS）]于 2009 年至 2010 年进行。根据临床和实验室标准协会推荐的口服青霉素 V 折点，青霉素不敏感肺炎链球菌（PNSSP）的流行率为 46%至 100%。阿奇霉素和克拉霉素对肺炎链球菌的耐药率为 0-88%，对 MSSA 的耐药率为 0-57%，对链球菌的耐药率为 0-76.5%。产超广谱β-内酰胺酶肺炎克雷伯菌的流行率为 5.1%至 58.5%。流感嗜血杆菌分离株的β-内酰胺酶产率为 15%至 46.6%，卡他莫拉菌分离株的β-内酰胺酶产率为 90%至 100%。卡他莫拉菌分离株的大环内酯类耐药率和头孢克洛耐药率分别为 5.8%和 1.2%，主要在中国内地。PNSSP 分离株的左氧氟沙星耐药率为 0-3.9%，最小抑菌浓度（MIC90）为 1-2mg/L，莫西沙星耐药率为 0-1.7%，MIC90 为 0.125-0.5mg/L。莫西沙星对链球菌、流感嗜血杆菌和卡他莫拉菌分离株非常有效，MIC90 值分别为 0.125-0.25、0.032-0.5 和 0.064-0.125mg/L。CARTIPS 研究的结果证实了肺炎链球菌、MSSA、肺炎克雷伯菌、流感嗜血杆菌和链球菌的抗菌药物敏感性在一些地区存在显著差异，强调了抗菌药物监测计划对指导经验性治疗和在不同地理区域集中控制抗菌药物耐药性的重要性。
