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• W2963515964 abstract "Antimicrobial resistance (AMR) is a global health threat that leads to increasing health care cost, treatment failures, and even deaths.1Wang J Liu F Tan JBX Harbarth S Pittet D Zingg W Implementation of infection prevention and control in acute care hospitals in Mainland China: a systematic review.Antimicrob Resist Infect Control. 2019; 8: 32Crossref PubMed Scopus (18) Google Scholar, 2Wang J Liu F Tartari E Huang J Harbarth S, Pittet et al.The prevalence of healthcare-associated infections in mainland China: a systematic review and meta-analysis.Infect Control Hosp Epidemiol. 2018; 39: 701-709Crossref PubMed Scopus (31) Google Scholar, 3Allegranzi B Bagheri Nejad S Combescure C Graafmans W Attar H Donaldson L et al.Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis.Lancet. 2011; 377: 228-241Abstract Full Text Full Text PDF PubMed Scopus (1155) Google Scholar The People's Republic of China faces similar health care problems toward emerging AMR as its neighboring countries.1Wang J Liu F Tan JBX Harbarth S Pittet D Zingg W Implementation of infection prevention and control in acute care hospitals in Mainland China: a systematic review.Antimicrob Resist Infect Control. 2019; 8: 32Crossref PubMed Scopus (18) Google Scholar International surveillance systems, such as the Global Antimicrobial Resistance Surveillance System and the European Antimicrobial Resistance Surveillance Network (EARS-Net), play an important role to present the updated information of the current status and the changing trends of AMR epidemic.4European Centre for Disease Prevention and ControlSurveillance of antimicrobial resistance in Europe.https://ecdc.europa.eu/sites/portal/files/documents/EARS-Net-report-2017-update-jan-2019.pdfDate: 2017Google Scholar, 5World Health OrganizationGlobal antimicrobial resistance surveillance system (GLASS) report, 2016-2017.https://www.who.int/glass/resources/publications/early-implementation-report/en/Date: 2017Google Scholar In China, there are 2 AMR surveillance networks: China Antimicrobial Resistance Surveillance System and China Antimicrobial Surveillance Network.6National Health Commission of the People's Republic of ChinaChina antimicrobial resistance surveillance system.2019http://www.carss.cn/Date: 2019Google Scholar, 7Hu F Guo Y Zhu D Wang F Jiang X Xu Y et al.Antimicrobial resistance profile of clinical isolates in hospitals across China: report from the CHINET surveillance program, 2017.Chin J Infect Chemother. 2018; 18: 241-251Google Scholar The main problem of Chinese AMR surveillance networks is that they focus on the AMR surveillance data from tertiary-care teaching hospitals, which are mostly geographically located in the southeastern region.7Hu F Guo Y Zhu D Wang F Jiang X Xu Y et al.Antimicrobial resistance profile of clinical isolates in hospitals across China: report from the CHINET surveillance program, 2017.Chin J Infect Chemother. 2018; 18: 241-251Google Scholar The findings cannot be considered as generalization for entire country. Furthermore, most international peer-review publications on the AMR topic in China are interesting in molecular characterization analysis, and the outcomes unfortunately are less beneficial for the epidemiology profile and population-based research on AMR. Recently, Hu et al8Hu F Zhu D Wang F Wang M Current status and trends of antibacterial resistance in China.Clin Infect Dis. 2018; 67: 128-134Crossref PubMed Scopus (99) Google Scholar summarized epidemiologic trends of AMR in China between 2005 and 2017. The bacterial resistance of gram-negative bacilli is still a major issue. Klebsiella pneumonia, Pseudomonas aeruginosa, and Acinetobacter baumannii resistance to carbapenems is emerging; strikingly, the proportion of imipenem resistance A baumannii increased from 31% in 2005 to 71% in 2017. Meanwhile, the proportion of cefotaxime- (third generation cephalosporins) resistant Escherichia coli was still stabilized in a high level, ranging from 59%-63%. Furthermore, Zhang et al9Zhang Y Wang Q Yin Y Chen H Jin L Gu B et al.Epidemiology of carbapenem-resistant Enterobacteriaceae infections: report from the China CRE Network.Antimicrob Agents Chemother. 2018; 62 (e01882-17)Crossref Scopus (147) Google Scholar assessed the population burden of carbapenem-resistant Enterobacteriaceae infection. To our best knowledge, this is the first study to show the incidence density of bloodstream infections due to carbapenem-resistant Enterobacteriaceae of 0.3 infections per 100,000 patient-days in China. This result is higher than the carbapenem-resistant E coli incidence density of 0.1 infections per 100,000 patient-days and carbapenem-resistant K pneumonia incidence density of 0.2 infections per 100,000 patient-days in a 2015 Swiss National surveillance study. The results from these Chinese studies have shown the alarming situation and the necessity of conducting nationwide AMR surveillance.10Gasser M Zingg W Cassini A Kronenberg A Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in Switzerland.Lancet Infect Dis. 2019; 19: 17-18Abstract Full Text Full Text PDF PubMed Scopus (19) Google Scholar In 2018, brief guidance for infection control of carbapenem-resistance Enterobacteriaceae was published by the National Health and Family Planning Commission of People's Republic of China.11Hu F Zhu D Brief introduction to facility guidance for control of carbapenem-resistant Enterobacteriaceae.Chin J Infect Chemother. 2018; 18: 331-335Google Scholar This document highlighted the prospective surveillance as a key component to prevent AMR. However, compared to EARS-Net protocol,12European Centre for Disease Prevention and ControlAntimicrobial resistance (AMR) reporting protocol 2018.https://ecdc.europa.eu/sites/portal/files/documents/EARS-Net%20reporting%20protocol%202018.%20docx.pdfDate: 2018Google Scholar methodologies (ie, data collection, data analysis, and data reporting) in the document were not specific enough to allow delivering information regarding AMR surveillance on the national level. Furthermore, compared to EARS-Net annual surveillance report,4European Centre for Disease Prevention and ControlSurveillance of antimicrobial resistance in Europe.https://ecdc.europa.eu/sites/portal/files/documents/EARS-Net-report-2017-update-jan-2019.pdfDate: 2017Google Scholar the results of main targeted bacterial resistances presented by China Antimicrobial Surveillance Network report7Hu F Guo Y Zhu D Wang F Jiang X Xu Y et al.Antimicrobial resistance profile of clinical isolates in hospitals across China: report from the CHINET surveillance program, 2017.Chin J Infect Chemother. 2018; 18: 241-251Google Scholar were not in detail and to some degree cannot provide useful guidance for infection control practitioners. Based on recommendations of EARS-Net protocol and other studies,4European Centre for Disease Prevention and ControlSurveillance of antimicrobial resistance in Europe.https://ecdc.europa.eu/sites/portal/files/documents/EARS-Net-report-2017-update-jan-2019.pdfDate: 2017Google Scholar, 12European Centre for Disease Prevention and ControlAntimicrobial resistance (AMR) reporting protocol 2018.https://ecdc.europa.eu/sites/portal/files/documents/EARS-Net%20reporting%20protocol%202018.%20docx.pdfDate: 2018Google Scholar health care–associated infections, or community-associated infections caused by multidrug-resistant organisms should be clearly distinguished. The first date of sample collection and isolated source from the same patient should be applied. Second, subgroups analyses of infections due to multidrug-resistant organisms are needed, in particular the infection burdens in different population groups (ie, adults, children, and neonates) and in different departments (ie, intensive care unit, surgery, and internal medicine). Finally, conducting the data analysis of bacteria resistance to 2 or more than 2 group-combinations (ie, E coli resistance to aminopenicillins + fluoroquinolones/+ third-generation cephalosporins) are recommended. In clinical perspective, it provides reference data for treating high-risk populations. On the national level, to standardize the AMR surveillance still has a long way to go. Now we should convince hospital managers, policy makers, and other stakeholders to take action. More resources should be allocated and directed toward national AMR surveillance projects, and more hospitals (including primary-care and secondary-care hospitals) should be convinced to participate in the nationwide AMR surveillance project." @default.
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• W2963515964 title "The challenges of antimicrobial resistance surveillance in China" @default.
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