ABSTRACT
Objective:
To
report the results of national
surveillance on the distribution and antimicrobial resistance profile of clinical bacterial isolates from
bloodstream infections in
China in 2021.
Methods:
The clinical bacterial
strains isolated from
blood culture from member
hospitals of
Blood Bacterial Resistant Investigation Collaborative System (BRICS) were collected during January 2021 to December 2021.
Antibiotic susceptibility tests were conducted by
agar dilution or broth
dilution methods recommended by
Clinical Laboratory Standards Institute (CLSI). WHONET 5.6 was used to analyze data.
Results:
During the study period, 11 013 bacterial
strains were collected from 51
hospitals, of which 2 782 (25.3%) were
Gram-positive bacteria and 8 231 (74.7%) were
Gram-negative bacteria. The top 10 bacterial species were
Escherichia coli (37.6%),
Klebsiella pneumoniae (18.9%),
Staphylococcus aureus (9.8%),
coagulase-negative Staphylococci (6.3%),
Pseudomonas aeruginosa (3.6%),
Enterococcus faecium (3.6%),
Acinetobacter baumannii (2.8%),
Enterococcus faecalis (2.7%),
Enterobacter cloacae (2.5%) and
Klebsiella spp (2.1%). The
prevalence of
methicillin-resistant Staphylococcus aureus (
MRSA) and
methicillin-resistant coagulase-negative
Staphylococcus aureus were 25.3% and 76.8%, respectively. No
glycopeptide- and
daptomycin-resistant Staphylococci was detected; more than 95.0% of
Staphylococcus aureus were sensitive to ceftobiprole. No
vancomycin-resistant Enterococci strains were detected. The rates of extended spectrum B-lactamase (ESBL)-producing isolated in
Escherichia coli,
Klebsiella pneumoniae and
Proteus mirabilis were 49.6%, 25.5% and 39.0%, respectively. The
prevalence rates of
carbapenem-resistance in
Escherichia coli and
Klebsiella pneumoniae were 2.2% and 15.8%, respectively; 7.9% of
carbapenem-resistant
Klebsiella pneumoniae was resistant to
ceftazidime/avibactam combination. Ceftobiprole demonstrated excellent activity against non-ESBL-producing
Escherichia coli and
Klebsiella pneumoniae.
Aztreonam/avibactam was highly active against
carbapenem-resistant
Escherichia coli and
Klebsiella pneumoniae. The
prevalence rate of
carbapenem-resistance in
Acinetobacter baumannii was 60.0%, while
polymyxin and
tigecycline showed good activity against
Acinetobacter baumannii (5.5% and 4.5%). The
prevalence of
carbapenem-resistance in
Pseudomonas aeruginosa was 18.9%.
Conclusions:
The BRICS
surveillance results in 2021 shows that the main pathogens of
blood stream infection in
China are
gram-negative bacteria, in which
Escherichia coli is the most common. The
MRSA incidence shows a further decreasing trend in
China and the overall
prevalence of
vancomycin-resistant Enterococci is low. The
prevalence of
Carbapenem-resistant
Klebsiella pneumoniae is still on a high level, but the trend is downwards.