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

BACKGROUND: To investigate the current state of antibacterial resistance of clinical isolates from hospitals in Shanghai, China. METHODS: Antimicrobial 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. RESULTS: Of 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. CONCLUSION: Antimicrobial 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.