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To investigate the gram-negative bacteria resistance in nationwide tietiary hospitals, understand the trend of antimicrobial resistance and provide scientific data for the rational use of antibiotis.
All the clinical isolates were collected from 18 hospitals and the minimal inhibitory concentrations (MICs) were tested using agar/broth dilution method recommended by Clinical and Laboratory Standards Institute (CLSI) in central laboratory.
A total of 4 681 pathogenic isolates from 18 tertiary hospitals in 18 cities nationwide over the period from July 2023 to June 2024 were studied. Based on the MIC results, Escherichia coli and Klebsiella pneumoniae showed extended spectrum β-lactamase (ESBLs) phenotype rates of 50.7% and 20.7%, respectively, ESBLs phenotype rate keeps going down. The ratio of carbapenems resistance Klebsiella pneumoniae (CRKP) was 35.4%, increased by 10 percentage points compared with the previous monitoring. Carbapenems, β-lactam combination agents and amikacin displayed desirable antibacterial activity against Enterobacterales, susceptibal rates were above 78%. In addition, tigacycline, eravacycline, colistin maintained good antibacterial activity against their respective effective bacteria/species, and the bacterial sensitivity rates by more than 90%. Resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannnii to imipennnem were 32.7% and 70.7% and multidrug-resistant (MDR) detection rates were 43.3% and 78.3%, Extensively drug-resistant (MDR) were 17.0% and 71.0%, respectively. Comparison of drug resistance rates from different wards, ages and specimen sources indicated that the proportion of resistance in Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii isolated from intensive care unit (ICU) were significantly higher than non-ICU. Resistance rates of Pseudomonas aeruginosa isolated from children were significantly lower than that in adults and the elderly. However, the detection rate of ESBLs phenotypes in Klebsiella pneumoniae in children was 57.1%, significantly higher than that in adults (16.3%) and the elderly (19.8%). In addition, the strains of Haemophilus influenzae from children had a higher resistance rates to cephalosporins, macrolides, and clindamycin than those in adults and the elderly. Comparisons of different specimen sources showed that the resistance rates of Acinetobacter baumannii isolated from urine specimens were significantly lower than that from other sources. No statistical differences were observed among other major bacterial species in different specimens, while the resistance rates of Pseudomonas aeruginosa in sputum specimens and Escherichia coli in source drainage fluids were slightly higher than those from other sources.
The detection rates of ESBLs phenotypes in Escherichia coli and Klebsiella pneumoniae have continued to decline, while the detection rates of CRKP and ampicillin-resistant Haemophilus influenzae have shown an upward trend, which requires continuous attention.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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