Current status and trends of antimicrobial resistance among clinical isolates in China: a retrospective study of CHINET from 2018 to 2022

Abstract

Antimicrobial resistance (AMR) is a pressing issue in China, with antibiotic therapy becoming less effective against bacterial infections. To address this challenge, the China Antimicrobial Surveillance Network (CHINET) was established in 2005 to monitor antimicrobial resistance in the country. This study analyzed the CHINET data from teaching hospitals and evaluated the trends of AMR in China from 2018 to 2022. A range of 163,636 to 301,917 isolates was obtained per year, with the majority being Gram-negative bacilli (69.0% to 71.8%). The proportion of important multidrug-resistant pathogens remained stable over the years. While the analysis showed diverse AMR profiles for different bacterial species. Over the five years, generally decreased resistance rates were observed from the majority of the tested species. For example, resistance to ceftriaxone decreased in Escherichia coli and Klebsiella pneumoniae, while resistance to imipenem and meropenem decreased in Pseudomonas aeruginosa. Moreover, resistance to methicillin, gentamicin, fosfomycin, and clindamycin also decreased in clinical Staphylococcus aureus isolates. On the other hand, resistance levels of Acinetobacter baumannii remained stable. Our study provides a comprehensive overview of the AMR profiles of common bacterial species in China and highlights the ongoing efforts to address this challenge.

Treatment of Central Nervous System Infection Caused by Multidrug-Resistant Acinetobacter baumannii with Intravenous and Intraventricular Colistin Sulfate: A Case Report and Literature Review

“…21 The monitoring data by the China Antimicrobial Surveillance Network (CHINET) showed that the resistance rate of CRAB to colistin sulfate was very low (around 1.0%). 22 Unfortunately, studies revealed that only 5% of intravenous colistin crossed into the CSF, and this penetration ratio did not exceed 25% even in patients with meningitis whose blood-brain barrier was disrupted. 23 IVT is a method of injecting a drug directly into the subarachnoid space through a lumbar puncture, allowing the drug to infiltrate the CSF without passing through the blood-brain barrier and reaching its effective concentration quickly.…”

Antimicrobial resistance of clinical bacterial isolates in China: current status and trends

“…The methods were consistent in all participating hospitals, which were verified every year. 6 The CARSS protocol of AST was the same with CHINET.…”

“… 8 , 9 The resistance rates of colistin and tigecycline in E. coli have fluctuated around 1.0% and 0.1%, respectively, over the recent 5 years. 6 …”

“… 9 The ceftazidime/avibactam resistance rate in K. pneumoniae isolates has been as low as 6% in the last two years. 6 The most common mechanism of carbapenem resistance in K. pneumoniae collected from children is KPC-2, but the prevalence of NDM, especially NDM-1, is higher than in adults in China. 10 , 11 The dominant clone of CRKP is ST11, which usually carries multiple resistance genes via plasmids and causes nosocomial infection outbreaks.…”

Nationwide genome surveillance of carbapenem-resistant Pseudomonas aeruginosa in Japan

“…The established national phenotypic antimicrobial resistance surveillance program—the Japan Nosocomial Infections Surveillance (JANIS) ( 19 , 20 )—reported that the carbapenem (meropenem) resistance rate of P. aeruginosa in hospitalized patients in Japan, as of 2020, was 10.5%. This was the average among representative countries where antimicrobial resistance surveillance for P. aeruginosa was once or is currently being performed; the resistance rate was 29.3% in India (ATLAS 2015–2019), 19.3% in China (CHINET 2020), 6.5% in Australia (ATLAS 2015–2019), 28.5% in Poland (EARS-net 2020), 15.7% in the Czech Republic (EARS-net 2020), 13.9% in Germany (EARS-net 2020), 12.6% in France (EARS-net 2020), and 3.7% in Finland (EARS-net 2020) ( 16 , 21 , 22 ).…”