中国细菌耐性现状英文版

1、outlinehistory of studies on antimicrobial resistance on streptococcus pneumoniae 19671970 1978 1980 1991 2001spread around the world first case of prsp first case of mdr mechanism of prspregional problemglobal problem-lactams (penicillin)macrolidesfluoroquinolonespenicillin resistance in in china i

2、n late 1990pnssp, penicillin non-susceptible s. pneumoniae; pisp, penicillin intermediate s. pneumoniae; prsp, penicillin resistant s. pneumoniae* aac 1998; 42: 2633penicillin resistance in in china in early 2000pnssp, penicillin non-susceptible s. pneumoniae; pisp, penicillin intermediate s. pneumo

3、niae; prsp, penicillin resistant s. pneumoniaepenicillin resistance in s. pneumoniae has been increasing markedly since 2000increasing trends of penicillin resistance in in china shanghai100 strains each yearbeijingmore than 100 strains each yearclinical strains isolated from childrens hospitalreaso

4、ns causing the rapid increasing of penicillin resistancedifference of penicillin resistance in isolated between adults and childrenpnssp, penicillin non-susceptible s. pneumoniae; pisp, penicillin intermediate s. pneumoniae; prsp, penicillin resistant s. pneumoniaeresistance of to macrolides mechani

5、sm of bacterial resistance:mosaic pbp genes in prspczechoslovakia (1987)usa (1983)south africa (1978)s sxn pen-sensitive s. pneumoniaestreptococcus ?pbp 2bmechanisms of resistance to macrolides(wang m. diagn microbial infect dis 2001; 39:187)trends of methicillin resistant spp. (mrs) in china5%-24%3

6、5%-60%50%-70%mechanism of mrsasummaryantimicrobial resistance in gram-positive coccinpenicillin resistance in s. pneumoniae has been increasing markedly since 2000 in chinanthe resistance rates of s. pneumoniae to macrolides such as erythromycin are very highnmethicillin-resistant staphylococci are

7、highly prevalentantimicrobial resistance rates of isolated in china in 2005 (n=3758)antimicrobial resistance rates of in china in 2005 (n=2234)extended-spectrum -lactamases (esbls) in enterobacteriaceae in china1, xiong z. diagn microbiol infect dis 2002; 44: 1952, ling tk. aac 2006; 50: 3743, jacob

8、y ga. chin j infect chemother 2006; 6: 361mechanisms involved in quinolone resistancenalterations in drug target enzymes (dna gyrase and/or topoisomerase iv) target modificationeffluxplasmid-mediated quinolone resistance: determinatsrsrrsrconjugationtransformationrqnrqnra: lancet, 1998, the u.s.qnrb

9、: aac, 2006, the u. s.qnrs: aac, 2005, japanqnrc: 7th nccm, 2007, chinaplasmid-mediated quinolone resistancesummaryantimicrobial resistance in gram-negative bacillinesbls-producing strains of and are common, and spreading from hospital to communitynquinolone resistance rates in are especially highnn

10、ew mechanisms of plasmid-mediated quinolone resistance emergedimportance of non-fermenters percentage of non-fermenters in gram-negative bacilli in shanghai hospitals(high incidence of non-fermenters in gram-negative bacillin45% (6686/15244) of gnb were non-fermenters in chinet (resistance surveilla

11、nce network in china) surveillance program in china in 2005 (wang f. chin j infect chemother 2006; 6: 289)nnon-fermenters increased from 41% in 1999 to 48% in 2001 in icu clinical isolates of gnb in nprs (nosocomial pathogens resistance surveillance) study program in china (wang h, chen mj. natl med

12、 j china 2003; 83:385)resistance profile of 6123 strains of non-fermenters against 8 antimicrobials in chinet in 2005 (wang f. chin j infect chemother 2006; 6:289 )antimicrobial agentsceftazidimecefepimepiperacillin-tazobactamcefoperazone-sulbactamimipenem meropenemciprofloxacinamikacinresistance ra

13、te (%)4145442343434146susceptibility rate (%)5246495254554848trends in antimicrobial resistance rates among strains of isolated from shanghai hospitals(%)* testing year, number of isolates in the parenthesesmechanisms of resistance to imipenem in nproducing of -lactamases:ndecreased permeability:xef

14、fluxinactivationdecreasedpermeabilitytrends in antimicrobial resistance rates among strains of isolated from shanghai hospitals(%)* testing year, number of isolates in the parenthesesantimicrobial resistance rates among icu strains of spp. in china between 2003 and 2004(%) (wang h, et al. chin j lab

15、 med 2005; 28: 1295)outbreak of carbapenem-resistant in beijing and guangzhou(wang h, et al. chin j lab med 2005; 28: 636)nmdr-ab, resistant to 3 of the following 5 drugs: pip/taz, caz, sul/cfp, gen, cip, imi 5% in 1995 67% in 2002 in bj 20% in 1998 57% in 2002 in gzn90%(35/39) strains produced oxa-

16、23 carbapenemasenpfge results indicated resistance colonies spread in each of 4 hospitals, mainly in patients with vap and surgical infectionslane 1-3, 5, 8, 11-16 pfge type a, indicating same colonyoutbreak of cos-ab in shanghai(yang l, et al. natl med j china 2006; 86: 592)noutbreak of cos-ab (col

17、istin-only-sensitive ) in some hospitals lane 5-10, 13-14, pfge type a lane 3-4, 12, pfge type btrends in antimicrobial resistance rates among strains of isolated from shanghai hospitals(%)summaryantimicrobial resistance in non-fermentersnthe isolation of non-fermenters has been increasing in recent yearsnthe resistance rates of non-fermenters have been increasingnmore than 20% strains of are resistant to imipene