Antimicrobial resistance in southern China: results of prospective surveillance in Dongguan city, 2017

J Hosp Infect. 2020 Jun;105(2):188-196. doi: 10.1016/j.jhin.2020.03.029. Epub 2020 Mar 31.


Background: Few studies have estimated the burden of infections due to antimicrobial-resistant (AMR) pathogens in China.

Aim: To summarize antimicrobial resistance and assess the frequency of community-associated infections (CAIs) and healthcare-associated infections (HCAIs) due to AMR pathogens in Dongguan city, China.

Methods: Seven acute care hospitals provided antimicrobial susceptibility data for 2017, from which 'bug-drug' combinations were analysed. To calculate incidence proportions of CAI and incidence densities of HCAI, data from three tertiary care hospitals were merged with patient data, obtained from the Dongguan Nosocomial Infection Surveillance System.

Findings: A total of 16,548 pathogens were analysed. Non-susceptibility to third-generation cephalosporins (3GCs) in Escherichia coli and Klebsiella pneumoniae was 43.9% and 30.2%, respectively. Non-susceptibility to carbapenems in Pseudomonas aeruginosa and Acinetobacter baumannii was 29.5% and 50.9%, respectively. A quarter of Staphylococcus aureus (26.3%) were non-susceptible to oxacillin. The incidence density of HCAI due to E. coli non-susceptible to 3GCs and fluoroquinolones combined was 0.09 (95% confidence interval: 0.07-0.11) per 1000 patient-days. Both E. coli and K. pneumoniae were the predominant pathogens isolated from blood. Compared with the 2017 European Antimicrobial Resistance Surveillance Network report, the incidence proportion of bloodstream infections due to multidrug-resistant E. coli was significantly higher (14.9% and 4.6%, respectively).

Conclusion: The incidence of non-susceptible bug-drug combinations in Dongguan city was lower compared with China as a whole. Non-susceptible bug-drug combinations were significantly more frequent in HCAI compared with CAI. The incidence proportion of bloodstream infections due to multidrug-resistant pathogens in Dongguan City was higher compared with Europe.

Keywords: Antimicrobial resistance; China; Dongguan; Incidence density; Incidence proportion; Multidrug-resistant pathogens; Surveillance.

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Bacteria / classification
  • Bacteria / drug effects*
  • Bacteria / pathogenicity
  • China / epidemiology
  • Community-Acquired Infections / epidemiology*
  • Community-Acquired Infections / microbiology
  • Cost of Illness
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • Drug Resistance, Multiple, Bacterial*
  • Epidemiological Monitoring*
  • Humans
  • Microbial Sensitivity Tests
  • Prospective Studies


  • Anti-Bacterial Agents