Xiao, Y. H. et al. Epidemiology and characteristics of antimicrobial resistance in China. Drug. Resist. Updat. 14, 236-250

ArticleinDrug resistance updates: reviews and commentaries in antimicrobial and anticancer chemotherapy 14(4-5):236-50 · August 2011with29 Reads
DOI: 10.1016/j.drup.2011.07.001 · Source: PubMed
Abstract
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.
    • "Staphylococcus aureus is an opportunistic pathogen that can rapidly develop resistance to antimicrobial agents (Pantosti et al., 2007). Methicillin-resistant S. aureus (MRSA) isolates are common pathogens in hospitals world-wide (Edelsberg et al., 2014; Xiao et al., 2011). Antibiotic resistance in S. aureus can emerge through point mutations or horizontal gene transfer of mobile genetic elements (MGEs). "
    [Show abstract] [Hide abstract] ABSTRACT: Whole-genome sequencing (WGS) was used to investigate the genetic features of the recently identified lsa(E) gene in porcine S. aureus ST9 isolates. Three quinupristin/dalfopristin-resistant isolates harboring the lsa(E) gene (two MRSA and one MSSA) were sequenced. Phylogenetic analysis of 184S. aureus genomes showed that ST9 porcine isolates belong to a distinct sequence cluster. Further analysis showed that all isolates were deficient in the recently described type IV restriction-modification system and SCCmec type XII was identified in the two MRSA isolates, which included a rare class C2 mec gene complex. A 24kb ΨSCC fragment was found in the MRSA and MSSA isolates sharing 99% nucleotide sequence homology with the ΨSCCJCSC6690 (O-2) element of a ST9 MRSA isolate from Thailand (accession number AB705453). Comparison of these ST9 isolates with 181 publically available S. aureus genomes identified 24 genes present in all (100%) ST9 isolates, that were absent from the most closely related human isolate. Our analysis suggests that the sequenced quinupristin/dalfopristin-resistant ST9 lineage represent a reservoir of mobile genetic elements associated with resistance and virulence features.
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    • "Infections due to antimicrobial-resistant pathogens are a growing problem all over the world. In developing countries like India and China, antimicrobial resistance is particularly prevalent, owing to previous unregulated overuse of antimicrobials [20, 21] . S. aureus is one of the commonest Gram-positive bacterial pathogens, and in many places, the majority of S. aureus infections are now caused by multidrug-resistant strains, including MRSA and vancomycinresistant S. aureus (VRSA). "
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    • "The spread of MRSA is also a serious issue in China. The proportion of MRSA among all S. aureus isolates has reached 50–70% based on former studies91011 . Due to the terrible prognosis of MRSA infections [7, 8], epidemiological information is urgently needed to help prevent and control these infections. "
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