ABSTRACT
Objective:
To investigate the bacterial composition and antimicrobial resistance profile of clinical isolates from
bloodstream infections in
China.
Methods:
The clinical bacterial
strains isolated from
blood culture were collected during January 2020 to December 2020 in member
hospitals of
Blood Bacterial Resistant Investigation Collaborative System (BRICS).
Antibiotic susceptibility tests were conducted by
agar dilution or broth
dilution methods recommended by
Clinical Laboratory Standards Institute(CLSI, USA). WHONET 5.6 was used to analyze data.
Results:
During the study period, 10 043 bacterial
strains were collected from 54
hospitals, of which 2 664 (26.5%) were
Gram-positive bacteria and 7 379 (73.5%) were
Gram-negative bacteria. The top 10 bacterial species were
Escherichia coli (38.6%),
Klebsiella pneumoniae (18.4%),
Staphylococcus aureus (9.9%),
coagulase-negative Staphylococci (7.5%),
Pseudomonas aeruginosa (3.9%),
Enterococcus faecium (3.3%),
Enterobacter cloacae (2.8%),
Enterococcus faecalis (2.6%),
Acinetobacter baumannii (2.4%) and
Klebsiella spp (1.8%). The
prevalence of
methicillin-resistant Staphylococcus aureus (
MRSA) and
methicillin-resistant coagulase-negative
Staphylococcus aureus were 27.6% and 74.4%, respectively. No
glycopeptide- and
daptomycin-resistant Staphylococci were detected. More than 95% of
Staphylococcus aureus were sensitive to
rifampicin and SMZco. No
vancomycin-resistant Enterococci strains were detected. Extended spectrum β-lactamase (ESBL) producing
Escherichia coli,
Klebsiella pneumoniae and
Proteus mirabilis were 48.4%, 23.6% and 36.1%, respectively. The
prevalence rates of
carbapenem-resistance in
Escherichia coli and
Klebsiella pneumoniae were 2.3% and 16.1%, respectively; 9.6% of
carbapenem-resistant
Klebsiella pneumoniae strains were resistant to
ceftazidime/avibactam combination. The
prevalence rate of
carbapenem-resistance in
Acinetobacter baumannii was 60.0%, while
polymyxin and
tigecycline showed good activity against
Acinetobacter baumannii. The
prevalence rate of
carbapenem-resistance of
Pseudomonas aeruginosa was 23.2%.
Conclusions:
The
surveillance results in 2020 showed that the main pathogens of
bloodstream infection in
China were
gram-negative bacteria, while
Escherichia coli was the most common pathogen, and ESBL-producing
strains declined while
carbapenem-resistant
Klebsiella pneumoniae kept on high level. The proportion and the
prevalence of
carbapenem-resistant
Pseudomonas aeruginosa were on the rise slowly. On the other side, the
MRSA incidence got lower in
China, while the overall
prevalence of
vancomycin-resistant Enterococci was low.