Antimicrobial Resistance Trends of the Most Common Causative Pathogens Associated with Community-acquired Respiratory Infections in China: 2009–2018

Abstract

Background Emergence of antimicrobial resistance poses new challenges in the management of community acquired respiratory tract infections (CARTIs). Therefore, surveillance on the antimicrobial susceptibilities of common respiratory pathogens is valuable and guides empirical therapeutic choices in management of CARTIs. Objective The objective of the current study is to summarize the antimicrobial resistance trends in common respiratory tract pathogens isolated from patients with CARTIs in China, over a 10-year period (2009–2018). Methods Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis strains were collected from multicenter, and antimicrobial susceptibility testing was performed in the research central laboratory of each study period from 2009–2018. The pathogens that accounted for CARTIs in the adult population was considered and summarized. Results From 2009–2018 a total of 3750 isolates were collected from 22 cities located across different regions of China. Among these the most common bacterial isolates include S. pneumoniae (53.7%) followed by H. influenza (32.4%), M. catarrhalis (13.9%). S. pneumoniae exhibited reduction in susceptibility and increase in resistance to penicillin, cephalosporins (cefaclor, cefuroxime, ceftriaxone) during the surveillance period. Invasive and noninvasive S. pneumoniae showed similar resistance. In the case of H. influenzae susceptibility to β-lactam and β-lactamase inhibitors (ampicillin, amoxicillin and AMC), SXT, clarithromycin and cephalosporins (cefuroxime, cefaclor, ceftazidime) was reduced over the past 10 years with an exception of ceftriaxone. Overall, moxifloxacin and levofloxacin have the highest susceptibility rates against S. pneumoniae (>95%) and H. influenza (>90%). M. catarrhalis exhibited susceptibility to almost all the tested antimicrobials. Conclusion In China the 10-year trends showed a substantial increase in resistance to β-lactam drugs and reduction in sensitivity. However, certain antimicrobial agents namely fluoroquinolones including moxifloxacin and levofloxacin maintained low resistance rates with better susceptibility. Further, with few exceptions decline in susceptibility rates to macrolides and cephalosporins was observed among the tested pathogens.

Isolation and Antimicrobial Resistance Patterns of Bacterial Pathogens from Community‐Acquired Pneumonia at Adama Hospital Medical College, Adama, Ethiopia

“…M. catarrhalis showed 73.3%, 60.0%, and 53.3% resistance rates to azithromycin, erythromycin, and trimethoprim-sulfamethoxazole, whereas P. aeruginosa showed 45.5% resistance rate to cefepime. In contrary with our findings, a study done in China showed a high level of sensitivity of M. catarrhalis to azithromycin, 100%, and trimethoprim-sulfamethoxazole, 67.7% [ 11 ]. The higher resistance pattern observed in this study could be associated with several factors, including the widespread irrational use of drugs prior to patients visiting health facilities and the increasing circulation of drug-resistant isolates in the community warranting continues monitoring of the resistance profile in the community.…”

Impact of the COVID-19 pandemic on Haemophilus influenzae infections in pediatric patients hospitalized with community acquired pneumonia

“…Consistent with prior studies 14 , 26 , 30 , 31 , our study noted minimal resistance to rifamycins, fluoroquinolones, and third-generation cephalosporins. H. influenzae isolates resistant to fluoroquinolones are generally uncommon in children and have been mainly isolated from older people with chronic lung diseases exposed to frequent quinolone treatments 32 – 34 .…”

A Hospital-Based and Cross-Sectional Investigation on Clinical Characteristics of Pediatric Streptococcus pneumoniae Isolates in Beijing from 2015 to 2021

“… 8 , 25 However, in contrast to pediatric patients, the resistance of Streptococcus pneumoniae to common antibiotics was increasing over time in adult patients from 2009 to 2018, in a tertiary hospital in Beijing, China, with patients aged <18 years old excluded from study. 26 …”