Distribution of pathogens and antimicrobial resistance: An analysis of China healthcareassociated infection crosssectional survey in 2010

Abstract:

ObjectiveTo study the distribution and antimicrobial resistance of pathogens causing healthcareassociated infection (HAI) and communityassociated infection (CAI).MethodsStatistical analysis was conducted based on data about the distribution and antimicrobial resistance of pathogens reported to China healthcareassociated infection crosssectional survey of National Healthcareassociated Infection Surveillance System from March 1 to December 31, 2010.ResultsA total of 6 965 strains of pathogens causing HAI were isolated from 740 hospitals, 20.69% of which were grampositive bacteria, 66. 03% were gramnegative ones, and 10. 62% were fungi; Pseudomonas aeruginosa ranked at the top of the pathogens causing HAI(17.17%), followed by Escherichia coli (13.51%), Acinetobacter baumannii (11.01%), Klebsiella pneumoniae (10.73%), and Staphylococcus aureus (8.38%), the above bacteria constituted 61.25% (4 266/6 965) of pathogens causing HAI. 13 653 strains of pathogens causing CAI were isolated, 28.68% of which were grampositive bacteria, 46.90% were gramnegative ones, and 10.41% were fungi; Escherichia coli ranked at the top of the pathogen causing CAI (12.14%), followed by Pseudomonas aeruginosa (7.75%),other Streptococcus (6.28%), Staphylococcus aureus (5.51%), and virus(5.33%), which in total accounted for 37.01% (5 053/13 653) of pathogens causing CAI. The isolation rate of cefoxitinresistant Staphylococcus aureus and Staphylococcus epidermidis was 75.28% and 67.86% respectively in HAI, and 49.23% and 56.09% respectively in CAI; Resistant rate of Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa to ceftazidime ranged from 34.24% to 62.89%, with a higher rate of around 10% in HAI than that in CAI (all P<0.01). The resistant rate of Acinetobacter baumannii to cefoperazonesulbactam was 40.00% and 59.33% in CAI and HAI respectively.ConclusionThe distribution of pathogens causing HAI is highly concentrated, and the infection caused by nonfermentative bacteria is quite serious; distribution and antimicrobial resistance of pathogens are different in HAI and CAI, therefore, the usage of antimicrobial agents in clinical should be different accordingly.