Antimicrobial susceptibility of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis isolated from community-acquired respiratory tract infections in China: Results from the CARTIPS Antimicrobial Surveillance Program

Yawei Zhang; Feifei Zhang; Hui Wang; Chunjiang Zhao; Zhanwei Wang; Bin Cao; Yan Du; Xianju Feng; Yunjian Hu; Bijie Hu; Ping Ji; Zhiyong Liu; Yong Liu; Wanzhen Liao; Juan Lu; Hongli Sun; Zhongxin Wang; Xiuli Xu; Xuesong Xu; Qing Yang; Yunsong Yu; Rong Zhang; Chao Zhuo

doi:10.1016/j.jgar.2016.03.002

Antimicrobial susceptibility of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis isolated from community-acquired respiratory tract infections in China: Results from the CARTIPS Antimicrobial Surveillance Program

J Glob Antimicrob Resist. 2016 Jun:5:36-41. doi: 10.1016/j.jgar.2016.03.002. Epub 2016 Apr 30.

Authors

Yawei Zhang¹, Feifei Zhang¹, Hui Wang², Chunjiang Zhao¹, Zhanwei Wang¹, Bin Cao³, Yan Du⁴, Xianju Feng⁵, Yunjian Hu⁶, Bijie Hu⁷, Ping Ji⁸, Zhiyong Liu⁹, Yong Liu¹⁰, Wanzhen Liao¹¹, Juan Lu¹², Hongli Sun¹³, Zhongxin Wang¹⁴, Xiuli Xu¹⁵, Xuesong Xu¹⁶, Qing Yang¹⁷, Yunsong Yu¹⁸, Rong Zhang¹⁹, Chao Zhuo²⁰

Affiliations

¹ Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China.
² Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China. Electronic address: wanghui@pkuph.edu.cn.
³ Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
⁴ Department of Clinical Laboratory, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
⁵ Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
⁶ Department of Clinical Laboratory, Beijing Hospital, Beijing, China.
⁷ Department of Infectious Diseases, Zhongshan Hospital, Fudan University, Shanghai, China.
⁸ Department of Clinical Laboratory, The First Teaching Hospital of Xinjiang Medical University, Urumqi, China.
⁹ Department of Clinical Laboratory, Southwest Hospital, Chongqing, China.
¹⁰ Department of Clinical Laboratory, Shengjing Hospital of China Medical University, Shenyang, China.
¹¹ Department of Clinical Laboratory, The First Affiliated Hospital of Nanchang University, Nanchang, China.
¹² Department of Clinical Laboratory, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
¹³ Department of Clinical Laboratory, Peking Union Medical College Hospital, Beijing, China.
¹⁴ Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
¹⁵ Department of Clinical Laboratory, Xijing Hospital, Xi'an, China.
¹⁶ Department of Clinical Laboratory, China-Japan Union Hospital of Jilin University, Jilin, China.
¹⁷ Department of Clinical Laboratory, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
¹⁸ Department of Infectious Diseases, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
¹⁹ Department of Clinical Laboratory, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
²⁰ Department of Infectious Diseases, Guangzhou Institute of Respiratory Disease, Guangzhou, China.

PMID: 27436464
DOI: 10.1016/j.jgar.2016.03.002

Abstract

This study investigated the antimicrobial susceptibilities of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis isolates causing adult community-acquired respiratory tract infections (CARTIs) in China. A multicentre resistance surveillance study (CARTIPS) investigating 1046 clinical isolates from 19 hospitals in China was conducted from 2013 to 2014. Based on the minimum inhibitory concentration (MIC) breakpoints of oral penicillin, the percentages of penicillin-resistant, penicillin-intermediate and penicillin-susceptible S. pneumoniae were 44.1%, 13.7%, and 42.2%, respectively. The rates of penicillin-non-susceptible S. pneumoniae ranged from 27.9% to 72.2% in different cities, with the highest rate in Nanchang. Macrolides, including azithromycin, clarithromycin and erythromycin, showed the lowest activities against S. pneumoniae isolates, with resistance rates of 90.5%, 92.2% and 93.0%, respectively. However, 98% of these strains were susceptible to levofloxacin and moxifloxacin. For H. influenzae isolates, most of the antimicrobials agents exhibited good activities. However, ampicillin and trimethoprim/sulfamethoxazole showed relatively lower activity against H. influenzae, with resistance rates of 35.0% and 54.4%, respectively. β-lactamase production rates amongst H. influenzae and M. catarrhalis were 31.0% and 87.1%, respectively. In addition, a total of 15 β-lactamase-negative ampicillin-resistant (BLNAR) strains identified in this study were resistant to ampicillin, amoxicillin/clavulanic acid, cefaclor and cefuroxime. Most of the antimicrobial agents showed excellent activity against M. catarrhalis, with susceptibility rates of >90%. The results from the current study confirmed the regional variations in antimicrobial susceptibility of major CARTI pathogens and provided some choices for the treatment of these organisms. Continuous national surveillance of the epidemiology of CARTIs is strongly warranted in China.

Keywords: Antimicrobial resistance; Community-acquired respiratory tract infection; Surveillance.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Anti-Bacterial Agents / pharmacology*
China
Drug Resistance, Bacterial*
Haemophilus influenzae / drug effects*
Humans
Moraxella catarrhalis / drug effects*
Respiratory Tract Infections / microbiology
Streptococcus pneumoniae / drug effects*

Substances

Anti-Bacterial Agents