Antimicrobial susceptibility of Pseudomonas aeruginosa in China: a review of two multicentre surveillance programmes, and application of revised CLSI susceptibility breakpoints.

The aim of this study was to review the antimicrobial susceptibility of Pseudomonas aeruginosa in China from two nationwide surveillance programmes, namely Surveillance by Etest and Agar Dilution of Nationwide Isolate Resistance (SEANIR) and the Study for Monitoring Antimicrobial Resistance Trends (SMART). A total of 1479 and 187 P. aeruginosa isolates were collected in SEANIR 2005-2008 and SMART 2008-2010, respectively. Minimum inhibitory concentrations of β-lactam/β-lactamase inhibitor combinations, cephalosporins, carbapenems, aminoglycosides and fluoroquinolones were determined and were interpreted following recently revised Clinical and Laboratory Standards Institute (CLSI) guidelines. From SMART, isolation rates of P. aeruginosa were observed to increase by year; moreover, decreasing trends in activity of all antimicrobials were seen. Multidrug-resistant P. aeruginosa strains accounted for 25.2% of SEANIR and 23.0% of SMART isolates. By applying new CLSI interpretive criteria, susceptibilities to piperacillin/tazobactam and carbapenems decreased by 5.4-12.8%. Antimicrobial resistance of the pseudomonads, including P. aeruginosa, remains a challenge for clinical treatment in China. This review emphasises the need for antibiotic stewardship and longitudinal surveillance.