[Report of antimicrobial resistance surveillance program in Chinese children in 2016]
1Microbiology Laboratory, Department of Clinical Laboratory, Children's Hospital of Fudan University, Shanghai 201102, China.
Insights
Antimicrobial resistance is a significant concern in Chinese children, with higher rates observed in neonatal patients. This study analyzed over 56,000 isolates, revealing concerning resistance patterns in common pediatric pathogens.
Area of Science:
- Microbiology
- Pediatrics
- Infectious Diseases
Background:
- Antimicrobial resistance (AMR) poses a growing global health threat.
- Understanding AMR patterns in pediatric populations is crucial for effective treatment strategies.
- China faces significant challenges in combating antimicrobial resistance.
Purpose of the Study:
- To determine the antimicrobial resistance profiles of bacterial isolates from children in China.
- To compare resistance rates between neonatal and non-neonatal patient groups.
- To identify leading pathogens and their susceptibility patterns.
Main Methods:
- A multicenter prevalence survey conducted in 10 tertiary children hospitals across China from January to December 2016.
- Antimicrobial susceptibility testing performed using standard laboratory methods, including E-test and disk diffusion.
- Data analyzed using WHONET 5.6 software, interpreting results per CLSI 2016 guidelines.
Main Results:
- Over 56,000 isolates were collected, with gram-negative bacteria comprising 58.5%.
- Leading pathogens included Escherichia coli, Staphylococcus aureus, and Streptococcus pneumoniae.
- High Meropenem resistance rates were observed in Klebsiella pneumoniae (27.4% in neonates) and Acinetobacter baumannii (49.7% in neonates, 53.4% in non-neonates).
- Methicillin-resistant Staphylococcus aureus (MRSA) rates were notably high: 46.2% in neonates and 33.3% in non-neonates.
Conclusions:
- The study highlights a concerning trend of antimicrobial resistance in Chinese children.
- Neonatal patients exhibit particularly high rates of resistance to critical antibiotics.
- Urgent interventions are needed to address the escalating antimicrobial resistance in pediatric populations in China.
Abstract:
Objective: To analyze the antimicrobial resistance profile in Chinese children. Methods: This was a prevalence survey. From January 1 through December 31, 2016, the isolates were collected from 10 tertiary children hospitals in China. Antimicrobial susceptibility testing was carried out by routine laboratory methods. The penicillin susceptibility of streptococcus pneumonia and Meropenem susceptibility of gram-negative bacteria were detected by E-test and disk diffusion method respectively. Antimicrobial susceptibility results were interpreted according to the criteria of Clinical and Laboratory Standards Institute (CLSI) Guideline 2016. The data of antimicrobial susceptibility testing of isolates from either the different patients (neonatal group and non-neonatal group) or various sources were analyzed by WHONET 5.6 software. Results: A total of 56 241 isolates were collected, of which 41.5% (23 328 isolates) were gram-positive organisms and 58.5% (32 886 isolates) gram-negative organisms. The five leading pathogens were Escherichia coli (7 995/56 214, 14.2%), Straphylococcus aureus (6 468/56 214, 11.5%), Streptococcus pneumonia (6 225/56 214, 11.1%), Haemophilus influenza (5 435/56 214, 9.7%) and Klebsiella pneumonia (4 523/56 214, 8.0%). The Meropenem resistance rates of Klebsiella pneumonia, Enterobacter cloacae, Escherichia coil, Pseudomonas aeruginosa, Acinetobacter baumonia isolates were 27.4% (326/1 189) , 8.1% (29/358) , 2.0% (27/1 362) , 19.5% (34/174) , 49.7% (230/463) in neonatal group and 15.4% (512/3 327) , 4.8% (40/841) , 2.3% (151/6 564) , 13.7% (252/1 840) , and 53.4% (860/1 611) in non-neonatal group. The Methicillin-resistant Staphylococcus aureus (MRSA) rates of neonatal group and non-neonatal group were 46.2% (649/1 404) and 33.3% (1 668/5 010) . The penicillin non-susceptible rates of Streptococcus pneumonia in the two groups were 17.6% (6/34) and 18.2% (1 121/6 158) respectively. The β-lactamase positive rates of Haemophilus pneumonia isolates in the neonatal group and non-neonatal groups were 33.8% (47/139) and 44.4% (2 345/5 282) respectively. Conclusion: This investigation highlights the worrisome trend of antimicrobial resistance in children, especially among neonatal patients in China.
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