Objective:To investigate the distribution characteristics of common bacteria and changes in antimicrobial resistance in intensive care unit(ICU)patients in 58 hospitals in Hubei Province from 2020–2023.Method:The ant...Objective:To investigate the distribution characteristics of common bacteria and changes in antimicrobial resistance in intensive care unit(ICU)patients in 58 hospitals in Hubei Province from 2020–2023.Method:The antimicrobial agents for antimicrobial susceptibility tests was selected based on the 2022 China Antimicrobial Resistance surveillance system(CARSS)technical scheme,and the specific experimental operation was based on the requirements of the CLSI M02 and M07 documents.The commercial instruments were used following the manufacturer’s instructions.The interpretation of antimicrobial susceptibility test results was based on the 2023 CLSI M100 standard.Results:There were 15585,19258,23423 and 22395 clinical isolates in the ICU from 2020 to 2023,respectively.Among them,gram-positive bacteria accounted for 20.5%(3190/15585),21.2%(4089/19258),21.6%(5067/23423)and 21.6%(4831/22395),respectively.Gram-negative bacteria accounted for 79.5%(12395/15585),78.8%(15169/19258),78.4%(18356/23423)and 78.4%(17564/22395)of the bacteria,respectively.The top 5 isolates of gram-positive bacteria were Staphylococcus aureus,Enterococcus faecium,Streptococcus pneumoniae,Enterococcus faecalis,Staphylococcus epidermidis and gram-negative bacteria were Klebsiella pneumoniae,Acinetobacter baumannii,Escherichia coli,Pseudomonas aeruginosa and Stenotrophomonas maltophil,respectively,but the proportions and rankings of the isolates in different years slightly differed.The detection rate of methicillin-resistant S.aureus(MRSA)decreased from 44.4%in 2020 to 36%in 2023,and that of methicillin-resistant coagulase-negative Staphylococcus(MRCNS)decreased from 79.8%in 2020 to 73.8%in 2022 and increased to 78.4%in 2023.The detection rates of both vancomycin-resistant E.faecium and E.faecalis were lower than 1%.The detection rate of carbapenem-resistant P.aeruginosa(CRPA)decreased from 25%in 2020 to 19.7%in 2022 and increased slightly to 20.6%in 2023.The detection rate of carbapenem-resistant A.baumannii(CRAB)decreased from 81.9%in 2020 to 79.7%in 2022 and increased to 82.9%in 2023.The detection rate of third-generation cephalosporin-resistant E.coli decreased from 59.8%in 2020 to 53.1%in 2022 and increased to 52.5%in 2023.The detection rate of fluoroquinolone-resistant E.coli decreased from 62.7%in 2020 to 50.2%in 2022 and increased slightly to 51.0%in 2023.The detection rate of carbapenem-resistant E.coli(CRECO)decreased from 3.3%in 2020 to 1.8%in 2022 and slightly increased to 2.1%in 2023.The detection rate of third-generation cephalosporin-resistant K.pneumoniae decreased from 34.3%in 2020 to 26.3%in 2022 and then increased to 32.4%in 2023.The detection rate of carbapenem-resistant K.pneumoniae(CRKPN)increased from 17.9%to 19.4%in 2020,decreased to 13.2%in 2022,and rose sharply to 20.4%in 2023.Conclusion:MRSA showed a continuous downwards trend from 2020 to 2023,while the detection rates of MRCNS and most multidrug-resistant gram-negative bacteria continuously decreased from 2020 to 2022 but tended to increase in 2023.Therefore,it is still necessary to strengthen the monitoring of bacterial resistance and rational application of antibiotics and actively and effectively control nosocomial infections.展开更多
Objective To investigate the impact of the coronavirus disease 2019(COVID-19)pandemic on the bacterial profile of lower respiratory tract infections(LRTIs)and the prevalence of major drug-resistant bacteria in Hubei P...Objective To investigate the impact of the coronavirus disease 2019(COVID-19)pandemic on the bacterial profile of lower respiratory tract infections(LRTIs)and the prevalence of major drug-resistant bacteria in Hubei Province,China,by comparing five-year periods before(2015-2019)and after(2020-2024)the pandemic.Methods A retrospective analysis was conducted on microbial culture and antimicrobial susceptibility test results from sputum and bronchoalveolar lavage fluid(BALF)samples obtained from patients with LRTIs.Pathogen distribution and the prevalence of key drug-resistant bacteria,including methicillin-resistant Staphylococcus aureus(MRSA),cefotaxime/ceftriaxone-resistant Enterobacterales,carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant Pseudomonas aeruginosa(CRPAE),carbapenem-resistant Acinetobacter baumannii(CRABA),ampicillin-resistant Haemophilus influ-enzae(ARHI),and penicillin/erythromycin-resistant Streptococcus pneumoniae(PRSP/ERSP),were compared between the two periods.Results The overall number of bacterial isolates significantly increased during the post-pandemic period.Gram-negative bacteria remained dominant,although their relative composition shifted.The detection rates of common community-acquired pathogens(Haemophilus influenzae,Streptococcus pneumoniae)decreased sharply during the strict control phase(2020-2022)but rebounded from 2023 to 2024.The overall prevalence of most key drug-resistant bacteria followed a decreasing trend.Notably,the detection rates of MRSA and cefotaxime/ceftriaxone-resistant Enterobacterales decreased most mark-edly(≥15%).The prevalence of CRE and CRABA followed a"decrease-then-increase"trend,while carbapenem-resistant Klebsiella pneumoniae detection rates remained higher than the 2015 baseline,and carbapenem-resistant Escherichia coli prevalence was on par with the 2015 level in 2024.Although the detection rate of CRABA tended to decrease,it remained above 60%.In contrast,the detection rate of the ERSP was consistently high(≥90%),whereas that of the ARHI exhibited a continuous upward trend(increasing by more than 30%).Conclusion The COVID-19 pandemic significantly altered the bacterial ecology and resistance patterns of LRTIs.While stringent public health measures initially suppressed the transmission of some resistant pathogens,they may have facilitated the subsequent emergence and spread of more formidable drug-resistant bacteria.Continuous surveillance and reinforced infection control measures are crucial in the post-pandemic era.展开更多
文摘Objective:To investigate the distribution characteristics of common bacteria and changes in antimicrobial resistance in intensive care unit(ICU)patients in 58 hospitals in Hubei Province from 2020–2023.Method:The antimicrobial agents for antimicrobial susceptibility tests was selected based on the 2022 China Antimicrobial Resistance surveillance system(CARSS)technical scheme,and the specific experimental operation was based on the requirements of the CLSI M02 and M07 documents.The commercial instruments were used following the manufacturer’s instructions.The interpretation of antimicrobial susceptibility test results was based on the 2023 CLSI M100 standard.Results:There were 15585,19258,23423 and 22395 clinical isolates in the ICU from 2020 to 2023,respectively.Among them,gram-positive bacteria accounted for 20.5%(3190/15585),21.2%(4089/19258),21.6%(5067/23423)and 21.6%(4831/22395),respectively.Gram-negative bacteria accounted for 79.5%(12395/15585),78.8%(15169/19258),78.4%(18356/23423)and 78.4%(17564/22395)of the bacteria,respectively.The top 5 isolates of gram-positive bacteria were Staphylococcus aureus,Enterococcus faecium,Streptococcus pneumoniae,Enterococcus faecalis,Staphylococcus epidermidis and gram-negative bacteria were Klebsiella pneumoniae,Acinetobacter baumannii,Escherichia coli,Pseudomonas aeruginosa and Stenotrophomonas maltophil,respectively,but the proportions and rankings of the isolates in different years slightly differed.The detection rate of methicillin-resistant S.aureus(MRSA)decreased from 44.4%in 2020 to 36%in 2023,and that of methicillin-resistant coagulase-negative Staphylococcus(MRCNS)decreased from 79.8%in 2020 to 73.8%in 2022 and increased to 78.4%in 2023.The detection rates of both vancomycin-resistant E.faecium and E.faecalis were lower than 1%.The detection rate of carbapenem-resistant P.aeruginosa(CRPA)decreased from 25%in 2020 to 19.7%in 2022 and increased slightly to 20.6%in 2023.The detection rate of carbapenem-resistant A.baumannii(CRAB)decreased from 81.9%in 2020 to 79.7%in 2022 and increased to 82.9%in 2023.The detection rate of third-generation cephalosporin-resistant E.coli decreased from 59.8%in 2020 to 53.1%in 2022 and increased to 52.5%in 2023.The detection rate of fluoroquinolone-resistant E.coli decreased from 62.7%in 2020 to 50.2%in 2022 and increased slightly to 51.0%in 2023.The detection rate of carbapenem-resistant E.coli(CRECO)decreased from 3.3%in 2020 to 1.8%in 2022 and slightly increased to 2.1%in 2023.The detection rate of third-generation cephalosporin-resistant K.pneumoniae decreased from 34.3%in 2020 to 26.3%in 2022 and then increased to 32.4%in 2023.The detection rate of carbapenem-resistant K.pneumoniae(CRKPN)increased from 17.9%to 19.4%in 2020,decreased to 13.2%in 2022,and rose sharply to 20.4%in 2023.Conclusion:MRSA showed a continuous downwards trend from 2020 to 2023,while the detection rates of MRCNS and most multidrug-resistant gram-negative bacteria continuously decreased from 2020 to 2022 but tended to increase in 2023.Therefore,it is still necessary to strengthen the monitoring of bacterial resistance and rational application of antibiotics and actively and effectively control nosocomial infections.
文摘Objective To investigate the impact of the coronavirus disease 2019(COVID-19)pandemic on the bacterial profile of lower respiratory tract infections(LRTIs)and the prevalence of major drug-resistant bacteria in Hubei Province,China,by comparing five-year periods before(2015-2019)and after(2020-2024)the pandemic.Methods A retrospective analysis was conducted on microbial culture and antimicrobial susceptibility test results from sputum and bronchoalveolar lavage fluid(BALF)samples obtained from patients with LRTIs.Pathogen distribution and the prevalence of key drug-resistant bacteria,including methicillin-resistant Staphylococcus aureus(MRSA),cefotaxime/ceftriaxone-resistant Enterobacterales,carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant Pseudomonas aeruginosa(CRPAE),carbapenem-resistant Acinetobacter baumannii(CRABA),ampicillin-resistant Haemophilus influ-enzae(ARHI),and penicillin/erythromycin-resistant Streptococcus pneumoniae(PRSP/ERSP),were compared between the two periods.Results The overall number of bacterial isolates significantly increased during the post-pandemic period.Gram-negative bacteria remained dominant,although their relative composition shifted.The detection rates of common community-acquired pathogens(Haemophilus influenzae,Streptococcus pneumoniae)decreased sharply during the strict control phase(2020-2022)but rebounded from 2023 to 2024.The overall prevalence of most key drug-resistant bacteria followed a decreasing trend.Notably,the detection rates of MRSA and cefotaxime/ceftriaxone-resistant Enterobacterales decreased most mark-edly(≥15%).The prevalence of CRE and CRABA followed a"decrease-then-increase"trend,while carbapenem-resistant Klebsiella pneumoniae detection rates remained higher than the 2015 baseline,and carbapenem-resistant Escherichia coli prevalence was on par with the 2015 level in 2024.Although the detection rate of CRABA tended to decrease,it remained above 60%.In contrast,the detection rate of the ERSP was consistently high(≥90%),whereas that of the ARHI exhibited a continuous upward trend(increasing by more than 30%).Conclusion The COVID-19 pandemic significantly altered the bacterial ecology and resistance patterns of LRTIs.While stringent public health measures initially suppressed the transmission of some resistant pathogens,they may have facilitated the subsequent emergence and spread of more formidable drug-resistant bacteria.Continuous surveillance and reinforced infection control measures are crucial in the post-pandemic era.
