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    • 1  Antimicrobial resistance of bacteria from blood specimens: surveillance report from Hunan Province Antimicrobial Resistance Surveillance System, 2012-2021
    YUAN Hong-xia ,  JIANG Jing ,  CHEN Li-hua ,  FU Chen-chao ,  LI Chen ,  LI Yan-ming ,  NING Xing-wang ,  LIU Jun ,  SHI Guo-min ,  TANG Man-juan ,  WU Jing-min ,  YANG Huai-de ,  ZHENG Ming ,  ZHOU Jie-ying ,  REN Nan ,  WU An-hua ,  HUANG Xun
    2024, 23(8):921-931. DOI: 10.12138/j.issn.1671-9638.20245433
    [Abstract](267) [HTML](6407) [PDF 1.21 M](7159)
    Abstract:
    Objective To understand the change in distribution and antimicrobial resistance of bacteria isolated from blood specimens of Hunan Province, and provide for the initial diagnosis and treatment of clinical bloodstream infection (BSI). Methods Data reported from member units of Hunan Province Antimicrobial Resistance Survei-llance System from 2012 to 2021 were collected. Bacterial antimicrobial resistance surveillance method was implemented according to the technical scheme of China Antimicrobial Resistance Surveillance System (CARSS). Bacteria from blood specimens and bacterial antimicrobial susceptibility testing results were analyzed by WHONET 5.6 software and SPSS 27.0 software. Results A total of 207 054 bacterial strains were isolated from blood specimens from member units in Hunan Province Antimicrobial Resistance Surveillance System from 2012 to 2021, including 107 135 (51.7%) Gram-positive bacteria and 99 919 (48.3%) Gram-negative bacteria. There was no change in the top 6 pathogenic bacteria from 2012 to 2021, with Escherichia coli (n=51 537, 24.9%) ranking first, followed by Staphylococcus epidermidis (n=29 115, 14.1%), Staphylococcus aureus (n=17 402, 8.4%), Klebsiella pneumoniae (17 325, 8.4%), Pseudomonas aeruginosa (n=4 010, 1.9%) and Acinetobacter baumannii (n=3 598, 1.7%). The detection rate of methicillin-resistant Staphylococcus aureus (MRSA) decreased from 30.3% in 2015 to 20.7% in 2021, while the detection rate of methicillin-resistant coagulase-negative Staphylococcus (MRCNS) showed an upward trend year by year (57.9%-66.8%). No Staphylococcus was found to be resistant to vancomycin, linezolid, and teicoplanin. Among Gram-negative bacteria, constituent ratios of Escherichia coli and Klebsiella pneumoniae were 43.9%-53.9% and 14.2%-19.5%, respectively, both showing an upward trend (both P<0.001). Constituent ratios of Pseudomonas aeruginosa and Acinetobacter baumannii were 3.6%-5.1% and 3.0%-4.5%, respectively, both showing a downward trend year by year (both P<0.001). From 2012 to 2021, resistance rates of Escherichia coli to imipenem and ertapenem were 1.0%-2.0% and 0.6%-1.1%, respectively; presenting a downward trend (P＜0.001). The resistant rates of Klebsiella pneumoniae to meropenem and ertapenem were 7.4%-13.7% and 4.8%-6.4%, respectively, presenting a downward trend (both P<0.001). The resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii to carbapenem antibiotics were 7.1%-15.6% and 34.7%-45.7%, respectively. The trend of resistance to carbapenem antibiotics was relatively stable, but has decreased compared with 2012-2016. The resistance rates of Escherichia coli to the third-generation cephalosporins from 2012 to 2021 were 41.0%-65.4%, showing a downward trend year by year. Conclusion The constituent ratio of Gram-negative bacillus from blood specimens in Hunan Province has been increasing year by year, while the detection rate of carbapenem-resistant Gram-negative bacillus remained relatively stable in the past 5 years, and the detection rate of coagulase-negative Staphylococcus has shown a downward trend.
    2  Antimicrobial resistance of bacteria: surveillance report from Hunan Provincial Antimicrobial Resistance Surveillance System, 2012-2021
    Ming ZHENG ,  Li-hua CHEN ,  Chen-chao FU ,  Chen LI ,  Yan-ming LI ,  Jun LIU ,  Xing-wang NING ,  Guo-min SHI ,  Jing-min WU ,  Huai-de YANG ,  Hong-xia YUAN ,  Nan REN ,  An-hua WU ,  Xun HUANG
    2023(12):1425-1437. DOI: 10.12138/j.issn.1671-9638.20233826
    [Abstract](34) [HTML](493) [PDF 1.26 M](244)
    Abstract:
    Objective To understand the distribution of frequently isolated pathogenic bacteria from clinical specimens and their antimicrobial resistance changes in Hunan Province from 2012 to 2021, and to provide scientific evidence for the formulation and evaluation of antimicrobial clinical administration policies. Methods Species identification, selection of quality control strains and antimicrobial susceptibility testing agents were conducted according to the technical scheme of the China Antimicrobial Resistance Surveillance System (CARSS). Duplicate strains were excluded based on the principle of counting the first strain in each case. Statistical analysis was performed by WHONET 5.6 software. The the variations in constituent ratio and resistance rate of strains were analyzed with linear trend test, and the magnitude of change was described with Pearson correlation coefficient. Results From 2012 to 2021, the number of clinically isolated bacteria in the analysis increased from 82 759 to 312 914, with Gram-negative bacteria accounting for 69.5%-72.4%. The major Gram-positive bacteria were Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Enterococcus faecalis and Enterococcus faecium, and the major Gram-negative bacteria were Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii and Enterobacter cloacae. Isolation rate of Gram-positive bacteria increased yearly (r=0.022, P=0.001). Isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) decreased from 34.3% to 24.8%. Isolation rates of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis were less than 3% and 2%, respectively, presenting a downward trend. The detection rate of penicillin-resistant Streptococcus pneumoniae (PRSP) decreased from 5.6% to 1.0%. Except cefoperazone sulbactam, resistance rates of Escherichia coli to other tested antimicrobial agents showed decreasing trends (r < 0, P=0.001). Isolation rates of third-generation cephalosporin-resistant Escherichia coli (CTX/CRO-R-EC) and carbapenem-resistant Escherichia coli (CREC) decreased year by year (from 70.5% to 45.3%, and 12.2% to 2.0%, respectively). Resistance rates of Klebsiella pneumo-niae to imipenem and meropenem have increased year by year, reaching 9.1% and 11.0% respectively in 2021, while isolation rate of carbapenem-resistant Pseudomonas aeruginosa (CRPA) decreased from 28.5% to 15.0%. Resistance rates of Acinetobacter baumannii to most antimicrobial agents were 40%-60%, and remained relatively stable. Isolation rate of carbapenem-resistant Acinetobacter baumannii (CRAB) ranged from 39.5% to 59.6%. Conclusion The clinical isolation rates of most important special antimicrobial-resistant bacteria have been decreasing year by year, while the resistance rate of Klebsiella pneumoniae to carbapenem agents gradually increased. Antimicrobial stewardship as well as the prevention and control of healthcare-associated infection on specific antimicrobial-resistant bacteria should continue to be implemented in the future. The coverage and quality of antimicrobial resistance surveillance in Hunan Province should continue to be improved.
    3  Antimicrobial resistance of Pseudomonas aeruginosa: surveillance report from Hunan Provincial Antimicrobial Resistance Surveillance System, 2012-2021
    Jian-long LIU ,  Chun-rong SONG ,  Min FU ,  Qiong HU ,  Li-hua CHEN ,  Chen-chao FU ,  Chen LI ,  Yan-ming LI ,  Jun LIU ,  Xing-wang NING ,  Guo-min SHI ,  Jing-min WU ,  Huai-de YANG ,  Hong-xia YUAN ,  Ming ZHENG ,  Xun HUANG ,  An-hua WU ,  Nan REN
    2023(12):1452-1459. DOI: 10.12138/j.issn.1671-9638.20233827
    [Abstract](30) [HTML](239) [PDF 993.20 K](173)
    Abstract:
    Objective To understand the distribution and changes in antimicrobial resistance of clinically isolated Pseudomonas aeruginosa (P. aeruginosa) in the member hospitals of Hunan Provincial Antimicrobial Resistance Surveillance System from 2012 to 2021. Methods Antimicrobial susceptibility testing by disk diffusion or automated instrument was performed on clinical isolates. Testing results were determined according to the standards of 2022 edition from American Clinical Laboratory Standards Institute (CLSI). Statistical analysis was performed by WHONET 5.6 software. Data were analyzed by trend test (Cochran-armitage) and Chi-square test with SPSS. Results A total of 176 441 strains of P. aeruginosa were surveilled by Hunan Provincial Antimicrobial Resistance Surveillance System from 2012 to 2021. 99.4% of the strains were isolated from hospitalized patients, and about 70% of the strains were isolated from respiratory specimens. 8.4% of P. aeruginosa were from children (0-17 years old), 91.6% were from adults. Antimicrobial susceptibility testing results showed that P. aeruginosa was most sensitive to polymyxin B over 10 years, with a resis-tance rate of less than 6%. Resistance rates to piperacillin, piperacillin/tazobactam, ceftazidime, cefepime, aztreonam, imipenem, amikacin, gentamicin, tobramycin, ciprofloxacin, levofloxacin, and polymyxin B all showed downward trends. A total of 29 920 carbapenem-resistant P. aeruginosa (CRPA) strains were detected. The average isolation rate of CRPA in this province was 18.0% over 10 years. CRPA detection rate from adult was 18.5%, higher than that from children (12.3%), and both showing downward trends. Conclusion The resistance rate of clinically isolated P. aeruginosa in Hunan Province to most commonly used antimicrobial agents is decreasing.
    4  Antimicrobial resistance of bacteria from cerebrospinal fluid specimens: surveillance report from Hunan Province Antimicrobial Resistance Survei-llance System, 2012-2021
    LIU Jun ,  CHEN Li-hua ,  FU Chen-chao ,  LI Chen ,  LI Yan-ming ,  NING Xing-wang ,  SHI Guo-min ,  WU Jing-min ,  YANG Huai-de ,  YUAN Hong-xia ,  ZHENG Ming ,  REN Nan ,  WU An-hua ,  HUANG Xun ,  TANG Man-juan
    2024, 23(8):932-941. DOI: 10.12138/j.issn.1671-9638.20245427
    [Abstract](121) [HTML](6258) [PDF 1.09 M](6972)
    Abstract:
    Objective To investigate changes in the distribution and antimicrobial resistance of bacteria isolated from cerebrospinal fluid (CSF) specimens in Hunan Province, and provide reference for correct clinical diagnosis and rational antimicrobial use. Methods Data reported by member units of Hunan Province Antimicrobial Resistance Surveillance System from 2012 to 2021 were collected according to China Antimicrobial Resistance Surveillance System (CARSS) technical scheme. Data of bacteria isolated from CSF specimens and antimicrobial susceptibility testing results were analyzed with WHONET 5.6 and SPSS 20.0 software. Results A total of 11 837 bacterial strains were isolated from CSF specimens from member units of Hunan Province Antimicrobial Resistance Surveillance System from 2012 to 2021. The top 5 strains were coagulase-negative Staphylococcus (n=6 397, 54.0％), Acinetobacter baumannii (n=764, 6.5%), Staphylococcus aureus (n=606, 5.1％), Enterococcus faecium (n=465, 3.9%), and Escherichia coli (n=447, 3.8%). The detection rates of methicillin-resistant coagulase-negative Staphyloco-ccus (MRCNS) and methicillin-resistant Staphylococcus aureus (MRSA) were 58.9%-66.3% and 34.4%-62.1%, respectively. No Staphylococcus spp. were found to be resistant to vancomycin, linezolid, and teicoplanin. The detection rate of Enterococcus faecium was higher than that of Enterococcus faecalis, and the resistance rates of Enterococcus faecium to penicillin, ampicillin, high concentration streptomycin and levofloxacin were all higher than those of Enterococcus faecalis (all P=0.001). Resistance rate of Streptococcus pneumoniae to penicillin was 85.0%, at a high level. Resistance rate of Escherichia coli to ceftriaxone was >60%, while resistance rates to enzyme inhibitors and carbapenem antibiotics were low. Resistance rate of Klebsiella pneumoniae to ceftriaxone was >60%, to enzyme inhibitors piperacillin/tazobactam and cefoperazone/sulbactam was >30%, to carbapenem imipenem and me-ropenem was about 30%. Resistance rates of Acinetobacter baumannii to most tested antimicrobial agents were ＞60%, to imipenem and meropenem were 59.0%-79.4%, to polymyxin B was low. Conclusion Among the bacteria isolated from CSF specimens, coagulase-negative Staphylococcus accounts for the largest proportion, and the overall resistance of pathogenic bacteria is relatively serious. Bacterial antimicrobial resistance surveillance is very important for the effective treatment of central nerve system infection.
    5  Antimicrobial resistance of Acinetobacter baumannii: surveillance report from Hunan Provincial Antimicrobial Resistance System, 2012-2021
    Si-di LIU ,  Li-hua CHEN ,  Chen-chao FU ,  Chen LI ,  Yan-ming LI ,  Jun LIU ,  Xing-wang NING ,  Guo-min SHI ,  Jing-min WU ,  Huai-de YANG ,  Hong-xia YUAN ,  Ming ZHENG ,  Xun HUANG ,  Nan REN ,  An-hua WU
    2023(12):1460-1467. DOI: 10.12138/j.issn.1671-9638.20233822
    [Abstract](47) [HTML](278) [PDF 961.19 K](180)
    Abstract:
    Objective To understand the epidemiology of clinically isolated Acinetobacter baumannii (A. baumannii) in Hunan Province. Methods Bacterial antimicrobial resistance surveillance was carried out according to the requirements of the technical program of National Antimicrobial Resistance Surveillance System. Clinical data of Acinetobacter spp. reported to Hunan Provincial Antimicrobial Resistance Surveillance System by multiple centers in Hunan Province from 2012 to 2021 were summarized and analyzed with reference to the standards of the American Clinical and Laboratory Standards Institute. Results A total of 169 438 strains of Acinetobacter spp. were detected during the 10-year period, with the detection rate of A. baumannii being the highest (82.74%). 70 923 strains (53.63%) of carbapenem-resistant A. baumannii (CRAB) and 58 149 strains (43.97%) of carbapenem-sensitive A. baumannii (CSAB) were detected respectively. Both CRAB and CSAB were detected most frequently in the age group >70 years, which were 34.44% and 32.02%, respectively. The percentage of CRAB and CSAB detected in the intensive care unit were 34.80% and 11.31%, respectively. CRAB and CSAB were mainly isolated from sputum/bronchoalveolar lavage fluid, followed by pus/secretion, urine, and blood. The resistance rates of CRAB to commonly used antimicrobial agents didn't change much during the 10-year period. Resistance rates of CRAB to ceftazidime and cefepime were both >84%, to ampicillin/sulbactam and piperacillin/tazobactam were both >82%, to aminoglycosides and quinolones were both >59%, to minocycline and polymyxin B were 15.9%-25.0% and 1.3%-6.9%, respectively. CSAB were sensitive to commonly used antimicrobial agents. Conclusion The isolation rate of CRAB is high and there is no significant change in resistance to commonly used antimicrobial agents.
    6  Antimicrobial resistance of bacteria isolated from urine specimens: surveillance report from Hunan Province Antimicrobial Resistance Surveillance System, 2012-2021
    Jian SHUI ,  Li-hua CHEN ,  Chen LI ,  Yan-ming LI ,  Jun LIU ,  Xing-wang NING ,  Jing-min WU ,  Huai-de YANG ,  Hong-xia YUAN ,  Ming ZHENG ,  Nan REN ,  An-hua WU ,  Xun HUANG ,  Chen-chao FU ,  Guo-min SHI
    2024, 23(4):448-457. DOI: 10.12138/j.issn.1671-9638.20245412
    [Abstract](30) [HTML](224) [PDF 1.05 M](281)
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    Objective To understand the distribution and antimicrobial resistance of bacteria from clinical urine specimens in Hunan Province, and provide scientific basis for anti-infection treatment of patients with urinary tract infection (UTI). Methods Bacterial resistance surveillance was carried out according to the technical scheme requirements of China Antimicrobial Resistance Surveillance System, antimicrobial susceptibility testing results were judged based on standard of American Clinical and Laboratory Standards Institute, data about strains and antimicrobial resistance of bacteria from urine specimens reported by member units of Hunan Province Antimicrobial Resistance Surveillance System in 2012-2021 were analyzed with WHONET 5.6 software. Results A total of 379 330 strains of bacteria were isolated from urine specimens in 2012-2021, Gram-negative and Gram-positive bacteria accounted for 75.3% (72.4%-76.0%) and 24.7% (24.0%-27.6%), respectively. The top 5 Gram-negative bacteria were Escherichia coli (48.3%), Klebsiella pneumoniae (8.4%), Proteus mirabilis (3.3%), Pseudomonas aeruginosa (3.0%) and Enterobacter cloacae (1.6%). The top 5 Gram-positive bacteria were Enterococcus faecium (8.1%), Enterococcus faecalis (6.6%), Staphylococcus epidermidis (1.9%), Staphylococcus aureus (1.9%) and Staphylococcus haemolyticus (1.4%). The constituent of bacteria isolated from urine specimens of patients in different gender and age groups were different. Escherichia coli ranked first, accounting for 34.8% and 57.2% in males and females, respectively, as well as 49.0% and 34.4% in adults and children, respectively. Escherichia coli maintained high susceptibility to carbapenems, amikacin, tigecycline, cefoperazone/sulbactam and furantoin, with resistance rate < 10%, while resistance to cefazolin, cefuroxime, ceftriaxone, cefotaxime and quinolones were relatively higher, with resistance rate >48%; resistance rates to ceftazidime, ceftriaxone, cefotaxime, cefepime and aztreonam presented decreased trend (all P < 0.001). Klebsiella pneumoniae maintained higher susceptibility to carbapenems, amikacin and tigecycline, with resistance rate < 11%, resistance rate to quinolones was much lower than that of Escherichia coli. Enterococcus faecium and Enterococcus faecalis maintained high susceptibility to vancomycin, teicoplanin and linezolid, with resistance rates < 5%; resistance rate of Enterococcus faecalis to ampicillin and furantoin was < 15%. Except for linezolid and minocycline, resistance rates of Enterococcus faecium to the other tested antimicrobial agents were all higher than Enterococcus faecalis. No Staphylococcus aureus was found to be resistant to vancomycin, linezolid and teicoplanin. Conclusion Escherichia coli is the main bacteria isolated from urine specimens from various member units of Hunan Province Antimicrobial Resistance Surveillance System. In early empirical treatment, clinical antimicrobial should be targetedly used as early as possible based on bacterial identification and antimicrobial susceptibility testing results, so as to improve treatment effectiveness and slow down the emergence of antimicrobial resistance.
    7  Antimicrobial resistance of bacteria from intensive care units: surveillance report from Hunan Province Antimicrobial Resistance Surveillance System, 2012-2021
    CHEN Li-hua ,  FU Chen-chao ,  LI Chen ,  LI Yan-ming ,  LIU Jun ,  NING Xing-wang ,  SHI Guo-min ,  WU Jing-min ,  YANG Huai-de ,  YUAN Hong-xia ,  ZHENG Ming ,  REN Nan ,  HUANG Xun ,  WU An-hua ,  ZHOU Jian-dang
    2024, 23(8):942-953. DOI: 10.12138/j.issn.1671-9638.20245425
    [Abstract](95) [HTML](6277) [PDF 1.25 M](7082)
    Abstract:
    Objective To investigate the distribution and antimicrobial susceptibility of clinically isolated bacteria from intensive care units (ICUs) in hospitals of Hunan Province Antimicrobial Resistance Surveillance System from 2012 to 2021. Methods According to China Antimicrobial Resistance Surveillance System, data of clinically isolated bacterial strains and antimicrobial susceptibility testing results of bacteria from ICUs reported by all member units of Hunan Province Antimicrobial Resistance Surveillance System were analyzed with WHONET 2022 software. Results From 2012 to 2021, the total number of bacteria isolated from ICUs of member units of the Hunan Province Antimicrobial Resistance Surveillance System was 5 777-22 369, with Gram-negative bacteria accounting for 76.1%-78.0% annually. Staphylococcus aureus ranked first among isolated Gram-positive bacteria each year. The top 5 bacteria among Gram-negative bacteria were Acinetobacter baumannii, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia. Detection rate of methicillin-resistant Staphylococcus aureus showed a downward trend year by year. No Staphylococcus spp. were found to be resistant to vancomycin, teicoplanin and linezolid. Detection rates of vancomycin-resistant Enterococcus faecalis and vancomycin-resistant Enterococcus faecium were 0.6-1.1% and 0.6%-2.2%, respectively. Resistance rates of Escherichia coli and Klebsiella pneumoniae to imipenem were 3.1%-5.7% and 7.7%-20.9%, respectively. Resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii to imipenem were 24.6%-40.1% and 76.1%-80.9%, respectively. Detection rates of carbapenem-resistant Pseudomonas aeruginosa declined year by year. Acinetobacter baumannii maintained high susceptibility to polymyxin B, with resistance rate ＜10%. Conclusion Antimicrobial resistance of bacteria from ICUs is serious. Carbapenem-resistant Enterobacteriales has an upward trend after 2019. It is nece-ssary to strengthen the surveillance of bacterial resistance and carry out multidisciplinary collaboration.
    8  Antimicrobial resistance of Enterococcus spp.: surveillance report from Hunan Province Antimicrobial Resistance Surveillance System, 2012-2021
    FU Chen-chao ,  CHEN Li-hua ,  LI Chen ,  LI Yan-ming ,  LIU Jun ,  NING Xing-wang ,  SHI Guo-min ,  WU Jing-min ,  YANG Huai-de ,  YUAN Hong-xia ,  ZHENG Ming ,  WU An-hua ,  HUANG Xun ,  REN Nan
    2024, 23(8):954-962. DOI: 10.12138/j.issn.1671-9638.20245432
    [Abstract](83) [HTML](6239) [PDF 888.84 K](7046)
    Abstract:
    Objective To understand the antimicrobial resistance of clinically isolated Enterococcus spp. in Hunan Province. Methods Surveillance data of Enterococcus spp. resistance from member units of Hunan Provincial Antimicrobial Resistance Surveillance System from 2012 to 2021 were collected. Data were cleaned according to a unified method, and WHONET 5.6 software was adopted for statistical analysis. Results From 2012 to 2021, a total of 110 652 non-repetitive Enterococcus spp. strains were included in the analysis, mainly Enterococcus faecalis and Enterococcus faecium, accounting for 46.9% (n=37 774) and 45.9% (n=36 968), respectively, followed by Enterococcus avium (2.5%, n=1 982), Enterococcus gallinarum (1.8%, n=1 428), and Enterococcus casseliflavus (1.5%, n=1 185). The main specimen sources of Enterococcus spp. was urine (51.8%, n=57 350), followed by secretions (9.6%, n=10 660) and bile (8.5%, n=9 377). From 2012 to 2021, the resistance rates of Enteroco-ccus faecalis to ampicillin, teicoplanin, and vancomycin were 5.5%-12.0%, 1.3%-2.0%, and 0.6%-1.4%, respectively. The resistance rates of Enterococcus faecium to ampicillin, teicoplanin, and vancomycin were 69.2%-85.0%, 1.5%-2.8%, and 0.7%-2.5%, respectively. Except for linezolid and minocycline, the resistance rates of Enterococcus faecium to tested antimicrobial agents were all higher than those of Enterococcus faecalis. The resistance rates of Enterococcus faecalis and Enterococcus faecium to vancomycin decreased from 1.4% and 2.1% in 2012 to 0.6% and 0.7% in 2021, respectively, presenting a decreased trend. Conclusion Clinically isolated Enterococcus spp. maintain high antimicrobial susceptibility to vancomycin and teicoplanin. Resistance rates of Enterococcus faecalis and Enterococcus faecium to vancomycin present decreased trends.
    9  Antimicrobial resistance of bacteria isolated from bile: surveillance report from Hunan Province Antimicrobial Resistance Surveillance System, 2012-2021
    LI Chen ,  CHEN Li-hua ,  LI Yan-ming ,  LIU Jun ,  NING Xing-wang ,  SHI Guo-min ,  WU Jing-min ,  YANG Huai-de ,  YUAN Hong-xia ,  ZHENG Ming ,  FU Chen-chao ,  REN Nan ,  HUANG Xun ,  WU An-hua
    2024, 23(8):963-974. DOI: 10.12138/j.issn.1671-9638.20245426
    [Abstract](77) [HTML](6233) [PDF 1.48 M](7020)
    Abstract:
    Objective To analyze the distribution and changing trend of antimicrobial resistance of bacteria isolated from bile from Hunan Province Antimicrobial Resistance Surveillance System. Methods Data of pathogens isolated from bile from Hunan Province Antimicrobial Resistance Surveillance System from 2012 to 2021 were collected. The constituent of bacteria and antimicrobial susceptibility testing results were analyzed by WHONET 5.6 software. Changes in antimicrobial resistance was analyze by trend chi-square test. Results The major pathogenic bacteria isolated from bile were Gram-negative bacteria, accounting for 70.84%. The top three isolated Gram-negative pathogens were Escherichia coli (30.14%), Klebsiella pneumoniae(12.15%), and Pseudomonas aeruginosa(5.18%), and the top two Gram-positive bacteria were Enterococcus faecium (10.34%)and Enterococcus faecalis(9.52%). The resistance rates of Klebsiella pneumoniae and Escherichia coli to imipenem were highest in 2012-2013, being 15.7% and 14.9%, respectively, presenting an downward trend (P<0.05); resistance rates to piperacillin/tazobactam and cefoperazone/sulbactam were <24%, presenting an upward trend year by year (P<0.05); the susceptibility rate to amikacin was >94%, to levofloxacin and ciprofloxacin was 15.5%-65.2%. The highest resis-tance rate of Pseudomonas aeruginosa to imipenem (32.0%) was higher than that of meropenem (22.9%), resis-tance rates to piperacillin/tazobactam and cefoperazone/sulbactam were <19%. The highest resistance rates of Acinetobacter baumannii to imipenem and meropenem were 59.4% and 62.6%, respectively, resistance rate to cefo-perazone/sulbactam was <48%, presenting an upward trend (P<0.05); the highest resistance rate to ciprofloxacin (60.8%) was higher than levofloxacin (48.7%); resistance rate to tigecycline was <8%. The resistance rates of Enterococcus faecium to penicillin and ampicillin were both higher than those of Enterococcus faecalis, presenting an upward trend (P<0.05). Resistance rate of Enterococcus faecium to vancomycin was lower than that of Enterococcus faecalis. The resistance rates of Enterococcus faecium to vancomycin and linezolid were 0.5%-4.5% and 0.5%-3.4%, respectively; resistance rates of Enterococcus faecalis to vancomycin and linezolid were 0.2%-1.7% and 0.5%-3.5%, respectively (both P<0.05), all presenting a downward trend (all P<0.05). Conclusion Pathogenic bacteria isolated from bile are mainly related to the intestinal flora. The resistance rates of Enterococcus faecalis and Enterococcus faecium to vancomycin and linezolid as well as resistance rate of Enterobacterales to carbapenem antibiotics all present a downward trend.
    10  Changes in antimicrobial resistance of Klebsiella spp., Hunan Province Antimicrobial Resistance Surveillance System, 2012-2021
    DOU Qing-ya ,  CHEN Li-hua ,  FU Chen-chao ,  LI Chen ,  LI Yan-ming ,  LIU Jun ,  NING Xing-wang ,  SHI Guo-min ,  WU Jing-min ,  YANG Huai-de ,  YUAN Hong-xia ,  ZHENG Ming ,  REN Nan ,  WU An-hua ,  HUANG Xun ,  REN Bi-qiong
    2024, 23(4):421-428. DOI: 10.12138/j.issn.1671-9638.20245410
    [Abstract](40) [HTML](321) [PDF 895.87 K](301)
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    Objective To investigate the change in antimicrobial resistance of all Klebsiella spp. and Klebsiella spp. isolated from pediatric patients in Hunan Province, provide evidence for rational use of antimicrobial agents in the medical institutions in this area. Methods Data about Klebsiella spp. from Hunan Province Antimicrobial Resistance Surveillance System in 2012-2021 were analyzed, and the results were judged according to M100 32nd edition standard of American Clinical and Laboratory Standards Institute (CLSI), WHONET 5.6 software was used to statistically analyze the results. Results A total of 361 539 Klebsiella spp. strains were isolated from hospitals in Hunan Province Antimicrobial Resistance Surveillance System in 2012-2021, Klebsiella pneumoniae accounted for 86.7%, and strains were mainly from respiratory tract specimens (66.5%). The resistance rate of Klebsiella spp. to imipenem and meropenem were about 10.0% in 2015-2021. The resistance rate to tigecycline decreased, with a resistance rate of 7.1% in 2012-2013 and an annual average resistance rate < 4.0% in 2018-2021. The resistance rate of bacteria to cefoperazone/sulbactam increased significantly in 2012-2021, with a rate of 13.3% in 2020-2021. Carbapenems resistance rates of Klebsiella spp. from pediatric patients in 2015-2021 were 3.5%-8.6%, and the resistance rates to tigecycline were all ≤3.8% in 2012-2021. The detection rates of carbapenem-resistant Klebsiella spp. in newborns, children aged 29 days-14 years, adults and elderly patients in 2020-2021 were 4.7%, 3.9%, 9.5% and 10.2%, respectively. Conclusion The resistance rates of Klebsiella spp. to carbapenems were low in 2012-2021, tigecycline-resistant strains have emerged, which should be paid attention to, antimicrobial agents should be used rationally to prevent and control the occurrence of healthcare-associated infection.
    11  Antimicrobial resistance of Escherichia spp.: surveillance report from Hunan Province Antimicrobial Resistance Surveillance System, 2012-2021
    LONG Fang-wei ,  CHEN Li-hua ,  FU Chen-chao ,  LI Chen ,  LI Yan-ming ,  NING Xing-wang ,  LIU Jun ,  SHI Guo-min ,  WU Jing-min ,  YUAN Hong-xia ,  ZHENG Ming ,  WU An-hua ,  HUANG Xun ,  YANG Huai-de ,  REN Nan
    2024, 23(8):975-983. DOI: 10.12138/j.issn.1671-9638.20245424
    [Abstract](73) [HTML](6205) [PDF 1001.69 K](6980)
    Abstract:
    Objective To understand the antimicrobial resistance of Escherichia spp. from member units of Hunan Province Antimicrobial Resistance Surveillance System from 2012 to 2021. Methods According to the technical scheme of China Antimicrobial Resistance Surveillance System (CARSS), data about Escherichia spp. and the antimicrobial susceptibility testing results reported from member units of Hunan Province Antimicrobial Resistance Surveillance System were analyzed by WHONET 5.6 software. Results From 2012 to 2021, a total of 476 351 clinically isolated Escherichia spp. were collected, 475 520 of which were Escherichia coli, accounting for 99.8%; 92.6% were isolated from inpatients; 39.3% were isolated from urine specimens. Over the past 10 years, the proportion of Escherichia spp. in total detected pathogens remained relatively stable, ranging 20%-23%, the lowest rate was 18.7% in 2012, and the highest rate was 22.9% in 2015. In the past 10 years, the resistance rates of Escherichia spp. to ampicillin, ceftriaxone, cefotaxime and ampicillin/sulbactam were >80%, >47%, >45%, and >39%, respectively; resistance rates to piperacillin/tazobactam, cefoperazone/sulbactam, and nitrofurantoin were all <8%, to tigecycline, amikacin, imipenem, and meropenem (except in 2012) were all <5%. Resistance of Escherichia spp. to 22 commonly clinically used antimicrobial agents fluctuated, but overall trend decreased year by year. The resistance rates of Escherichia spp. from patients in the intensive care unit (ICU), non-ICU patients, outpatients, and emergency patients to 22 clinically commonly used antimicrobial agents were compared among different departments, and the differences were statistically significant (all P<0.05). The resistance rates of Escherichia spp. isolated from ICU and non-ICU patients were compared, and except for tigecycline, the resistance rates to the other 21 antimicrobial agents were statistically different (all P<0.05). The resistance rates of Escherichia spp. isolated from patients to commonly clinically used antimicrobial agents were statistically different among patients of different age groups (all P<0.05). Conclusion Escherichia spp. isolated from patients in different years, departments, specimens, and ages have different resistance to commonly used antimicrobial agents. It is necessary to continue to strengthen the surveillance on bacterial resistance, so as to guide the rational choice of antimicrobial agents.

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