2478. Surveillance of antibacterial resistance among clinical isolates from hospitals in Shanghai: results of 2018

Abstract

BackgroundTo investigate the current state of antibacterial resistance of clinical isolates from hospitals in Shanghai, China.MethodsAntimicrobial susceptibility testing (AST) was carried out for the clinical isolates from 50 hospitals (including 30 grade A tertiary hospitals and 20 grade B tertiary hospitals/grade A secondary hospitals, and there were 3 children hospitals among them) according to a unified protocol using Kirby–Bauer(KB) method or automated AST systems. Results were analyzed according to CLSI 2018 breakpoints.ResultsOf the 144373 clinical isolates, Gram-positive cocci and Gram-negative bacilli accounted for 29.6% and 70.4%, respectively. The overall prevalence of MRSA in Staphylococcus aureus was 45.9% and 78.4% for MRCNS in coagulase-negative Staphylococcus. No strains were found resistant to vancomycin in Staphylococcus spp. 84.1% of the 1204 strains of non-meningitis S. pneumoniae isolated from children were penicillin-susceptible (PSSP), 15.9% were penicillin-nonsusceptible, including penicillin-intermediate (PISP, 10.5%) and penicillin-resistant (PRSP, 5.4%) strains. Of the 361 strains isolated from adults, 94.5%, 3.0% and 2.5% were PSSP, PISP, and PRSP, respectively. Vacomycin-resistance E. feacium was 0.7% and no vacomycin-resistant E. feacalis were identified. According to PCR results, most of these resistant strains were vanA genotype. The prevalence linezolid-nonsusceptible E. faecalis was about 1.6%, few E. feacium was resistant to Linezolid. The overall prevalence of ESBL-producing strains was 54.0% in E. coli, 35.0% in Klebsiella pneumoniae and 47.1% in Proteus mirabilis. Enterobacteriaceae isolates were still mainly susceptible to carbapenems. Overall, 11.7% and 11.2% of the Enterobacteriaceae isolates were resistant to imipenem and meropenem, respectively. The predominant organism of CRE isolates was K. pneumoniae. The prevalence of CRAB and CRPA were 62.5% and 28.7%, respectively.ConclusionAntimicrobial resistance remains to be a problematic issue in healthcare settings, especially in Gram-negative bacilli, effective infection-control measures should be promoted to tackle this critical threat.Disclosures All authors: No reported disclosures.