National bloodstream infection bacterial resistance surveillance report (2023) : Gram-negative bacteria
- VernacularTitle:2023年全国血流感染细菌耐药监测报告：革兰阴性菌
- Author:
Jinru JI
1
;
Zhiying LIU
;
Chaoqun YING
;
Qing YANG
;
Haishen KONG
;
Jiangqin SONG
;
Hui DING
;
Yanyan LI
;
Yuanyuan DAI
;
Haifeng MAO
;
Pengpeng TIAN
;
Lu WANG
;
Yongyun LIU
;
Yizheng ZHOU
;
Jiliang WANG
;
Yan JIN
;
Donghong HUANG
;
Hongyun XU
;
Peng ZHANG
;
Xinhua QIANG
;
Hong HE
;
Lin ZHENG
;
Junmin CAO
;
Zhou LIU
;
Ying HUANG
;
Yan GENG
;
Haiquan KANG
;
Dan LIU
;
Guolin LIAO
;
Lixia ZHANG
;
Fenghong CHEN
;
Yanhong LI
;
Baohua ZHANG
;
Haixin DONG
;
Xiaoyan LI
;
Donghua LIU
;
Qiuying ZHANG
;
Xuefei HU
;
Liang GUO
;
Sijin MAN
;
Dijing SONG
;
Rong XU
;
Youdong YIN
;
Kunpeng LIANG
;
Aiyun LI
;
Zhuo LI
;
Hongxia HU
;
Guoping LU
;
Jinhua LIANG
;
Qiang LIU
;
Yinqiao DONG
;
Jilu SHEN
;
Shuyan HU
;
Liang LUAN
;
Jian LI
;
Ling MENG
;
Dengyan QIAO
;
Xiusan XIA
;
Bo QUAN
;
Dahong WANG
;
Chunhua HAN
;
Xiaoping YAN
;
Fei LI
;
Shifu WANG
;
Ping SHEN
;
Yunbo CHEN
;
Yonghong XIAO
Author Information
- Publication Type:Journal Article
- Keywords: Gram-negative bacteria; Bloodstream infection; Resistance surveillance; China
- From: Chinese Journal of Clinical Infectious Diseases 2025;18(1):47-62
- CountryChina
- Language:Chinese
- Abstract: Objective:To report the results of bacterial resistant investigation collaborative system（BRICS）on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2023，and provide reference for clinical tretment of bloodstream infections and prevention and control of bacterial resistance.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of BRICS were collected during January 2023 to December 2023. 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 were used to analyze the data.Results:During the study period，11 492 strains of Gram-negative bacteria were collected from 60 hospitals，of which 10 098（87.9%）were Enterobacterales and 1 394（12.1%）were non-fermentative bacteria. The top 5 bacterial species were Escherichia coli（50.0%）， Klebsiella pneumoniae（26.1%）， Pseudomonas aeruginosa（5.1%）， Acinetobacter baumannii complex（5.0%）and Enterobacter cloacae complex（4.1%）. The ESBL-producing rates in Escherichia coli， Klebsiella pneumoniae and Proteus mirablilis were 46.8%（2 685/5 741），18.3%（549/2 999）and 44.0%（77/175），respectively. The prevalence of carbapenem-resistant Escherichia coli（CREC）and carbapenem-resistant Klebsiella pneumoniae（CRKP）were 1.3%（76/5 741）and 15.0%（450/2 999）；32.9%（25/76）and 78.0%（351/450）of CREC and CRKP were sensitive to ceftazidime/avibactam combination，respectively. 94.7%（72/76）and 90.2%（406/450）of CREC and CRKP were sensitive to aztreonam/avibactam combination. Furthermore，57.9%（44/76）and 79.1%（356/450）were sensitive to imipenem/relebactam combination. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex was 64.6%（370/573），while more than 80.0% of CRAB complex was sensitive to tigecycline，eravacycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa（CRPA）was 17.0%（99/581）. There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of important Gram-negative bacteria resistance among different regions in China，with statistically significant differences in the prevalence of CREC，CRKP，CRPA and CRAB complex（ χ2=10.6，28.6，10.8 and 19.3， P<0.05）. The prevalence of ESBL-producing Escherichia coli， CREC，CRAB complex and CRKP were higher in provincial hospitals than those in municipal hospitals（ χ2=12.5，9.8，12.7 and 57.8，all P<0.01）. Conclusions:Gram-negative bacteria are the main pathogens causing bloodstream infections in China，and Escherichia coli is ranked in the top，while the trend of Klebsiella pneumoniae increases continuously with time. CRKP infection shows a slow upward trend，CREC infecton maintains a low prevalence level，and CRAB complex infection continues to exhibit a high prevalence rate. The composition and resistance patterns of pathogens causing bloodstream infections vary to some extent across different regions and levels of hospitals in China.
