National bloodstream infection bacterial resistance surveillance report (2022) : Gram-negative bacteria
- VernacularTitle:2022年全国血流感染细菌耐药监测报告：革兰阴性菌
- Author:
Zhiying LIU
1
;
Yunbo CHEN
;
Jinru JI
;
Chaoqun YING
;
Qing YANG
;
Haishen KONG
;
Haifeng MAO
;
Hui DING
;
Pengpeng TIAN
;
Jiangqin SONG
;
Yongyun LIU
;
Jiliang WANG
;
Yan JIN
;
Yuanyuan DAI
;
Yizheng ZHOU
;
Yan GENG
;
Fenghong CHEN
;
Lu WANG
;
Yanyan LI
;
Dan LIU
;
Peng ZHANG
;
Junmin CAO
;
Xiaoyan LI
;
Dijing SONG
;
Xinhua QIANG
;
Yanhong LI
;
Qiuying ZHANG
;
Guolin LIAO
;
Ying HUANG
;
Baohua ZHANG
;
Liang GUO
;
Aiyun LI
;
Haiquan KANG
;
Donghong HUANG
;
Sijin MAN
;
Zhuo LI
;
Youdong YIN
;
Kunpeng LIANG
;
Haixin DONG
;
Donghua LIU
;
Hongyun XU
;
Yinqiao DONG
;
Rong XU
;
Lin ZHENG
;
Shuyan HU
;
Jian LI
;
Qiang LIU
;
Liang LUAN
;
Jilu SHEN
;
Lixia ZHANG
;
Bo QUAN
;
Xiaoping YAN
;
Xiaoyan QI
;
Dengyan QIAO
;
Weiping LIU
;
Xiusan XIA
;
Ling MENG
;
Jinhua LIANG
;
Ping SHEN
;
Yonghong XIAO
Author Information
- Keywords: Gram-negative bacteria; Antibacterial resistance; Bloodstream infection; China; Resistance surveillance
- From: Chinese Journal of Clinical Infectious Diseases 2024;17(1):42-57
- CountryChina
- Language:Chinese
- Abstract: Objective:To report the results of national surveillance on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2022.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of national bloodstream infection Bacterial Resistant Investigation Collaborative System（BRICS）were collected during January 2022 to December 2022. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 software were used to analyze the data.Results:During the study period，9 035 strains of Gram-negative bacteria were collected from 51 hospitals，of which 7 895（87.4%）were Enterobacteriaceae and 1 140（12.6%）were non-fermenting bacteria. The top 5 bacterial species were Escherichia coli（ n=4 510，49.9%）， Klebsiella pneumoniae（ n=2 340，25.9%）， Pseudomonas aeruginosa（ n=534，5.9%）， Acinetobacter baumannii complex（ n=405，4.5%）and Enterobacter cloacae（ n=327，3.6%）. The ESBLs-producing rates in Escherichia coli， Klebsiella pneumoniae and Proteus spp. were 47.1%（2 095/4 452），21.0%（427/2 033）and 41.1%（58/141），respectively. The prevalence of carbapenem-resistant Escherichia coli（CREC）and carbapenem-resistant Klebsiella pneumoniae（CRKP）were 1.3%（58/4 510）and 13.1%（307/2 340）；62.1%（36/58）and 9.8%（30/307）of CREC and CRKP were resistant to ceftazidime/avibactam combination，respectively. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex was 59.5%（241/405），while less than 5% of Acinetobacter baumannii complex was resistant to tigecycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa（CRPA）was 18.4%（98/534）. There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of main Gram-negative bacteria resistance among different regions，with statistically significant differences in the prevalence of CRKP and CRPA（ χ2=20.489 and 20.252， P<0.001）. The prevalence of CREC，CRKP，CRPA，CRAB，ESBLs-producing Escherichia coli and Klebsiella pneumoniae were higher in provinicial hospitals than those in municipal hospitals（ χ2=11.953，81.183，10.404，5.915，12.415 and 6.459， P<0.01 or <0.05），while the prevalence of CRPA was higher in economically developed regions（per capita GDP ≥ 92 059 Yuan）than that in economically less-developed regions（per capita GDP <92 059 Yuan）（ χ2=6.240， P=0.012）. Conclusions:The proportion of Gram-negative bacteria in bloodstream infections shows an increasing trend，and Escherichia coli is ranked in the top，while the trend of CRKP decreases continuously with time. Decreasing trends are noted in ESBLs-producing Escherichia coli and Klebsiella pneumoniae. Low prevalence of carbapenem resistance in Escherichia coli and high prevalence in CRAB complex have been observed. The composition ratio and antibacterial spectrum of bloodstream infections in different regions of China are slightly different，and the proportion of main drug resistant bacteria in provincial hospitals is higher than those in municipal hospitals.
