Surveillance of antimicrobial resistance in clinical isolates from Hubei province in 2008

Objective To investigate the resistance of clinical isolates from Hubei province to commonly used antimicrobial agents during 2008.Methods Disk diffusion method was used to determine the antimicrobial susceptibility.Data were analyzed by WHONET 5.4 software.Results A total of 24 272 clinical isolates were collected,including gram-positive cocci(32.7%) and gram-negative bacilli(63.1%).The top six pathogens were E.coli,coagulase-negative Staphylococcus,P.aeruginosa,S.aureus,Klebsiella spp.and Acinetobacter spp.The prevalence of MRSA and MRCNS were 56.1% and 79.3%,respectively.Several strains of Enterococcus with intrinsic resistance to vancomycin were found.The resistant rates of Enterobacteriaceae to cefoperazone-sulbactam and piperacillin-tazobactam were lower than 20%.Three strains of K.pneumoniae were resistant to carbapenems.ESBLs-producing strains accounted for 65.1%,44.7% and 25.3% in E.coli,Klebsiella spp.and P.mirabilis,respectively.Not more than 20% of P.aeruginosa and Acinetobacter spp.were resistant to cefoperazone-sulbactam.The prevalence of pan-resistant P.aeruginosa and A.baumannii was 1.8% and 8.0%,respectively.The resistance of Acinetobacter spp.to most antimicrobial agents other than SMZ-TMP,minocycline and cefoperazone-sulbactam was higher than that of P.aeruginosa.The resistance rates of S.maltophilia and Burkholderia spp.were 19.3%,25.8% to SMZ-TMP,4.1% and 54.5% to minocycline.Conclusions Two thirds of these clinical isolates are gram-negative bacilli,for which carbapenems are highly active.The resistance to most antimicrobial agents is increasing in the clinical isolates,especially nonfermentative bacteria,from Hubei province.