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20 March 2026, Volume 26 Issue 2
  

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    Original Article
  • The research hotspots and frontier of nosocomial infections during the period from 2020 to 2024
    LAI Yinjuan, XIE Sheng
    2026, 26(2): 111-117. https://doi.org/10.16718/j.1009-7708.2026.02.001
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    Objective To analyze the research hotspots and trends of nosocomial infections during the period from 2020 to 2024, and provide references and suggestions for future research. Methods The literature related to nosocomial infection from CNKI and Web of Science (WOS) databases published during the period from 2020 to 2024 were searched. The authors, countries, and keywords were analyzed by network co-occurrence analysis using CiteSpace 6.2.R3. Results A total of 1 132 articles were identified from the WOS database and 1 793 articles identified in the CNKI database. The United States published a large number of articles and established the world’s largest cooperation network. The authors with a relatively high number of publications include Yin Ruijie, Mehta Yatin, Duszynska Wieslawa, Li Liuyi, Wu Anhua, and Liu Yunxi. Cluster analysis found 14 clusters (WOS database) and 19 clusters (CNKI database) in the keyword co-occurrence network. It mainly covers three major themes of nosocomial infection: epidemiological characteristics, influencing factors, and prevention and control strategies as well as management measures. The key words bursts include antibacterial activity, multidrug-resistant organisms, gram-negative bacteria, machine learning, disinfection supply center, etiology, Omicron variant, cerebral infarction, logistic regression analysis, and multidisciplinary collaboration. Conclusions Future research should continue to promote academic exchanges and cooperation among research teams, and actively keep track of the latest developments in international research. The issues of microbial resistance, individualized infection prevention strategies, and multidisciplinary collaborative studies are likely to be the focus of future research.
  • Diagnosis and treatment of 19 cases of necrotizing soft tissue infection
    ZHANG Jianping, SHI Lingling, DING Luobing, SU Ruilong, SHI Weifa, GUO Zhimin
    2026, 26(2): 118-123. https://doi.org/10.16718/j.1009-7708.2026.02.002
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    Objective To analyze the early clinical characteristics, pathogenic microorganisms, treatment measures at early stage, and prognosis of patients with necrotizing soft tissue infection (NSTI) for improving early diagnosis and treatment of the disease. Method A retrospective analysis was conducted on patients with NSTI who were admitted to hospital from January 2019 to February 2024. The essential information of patients, including cause of injury, laboratory test results, early antibiotic use, time from admission to diagnosis, time from admission to surgery, laboratory risk index score for necrotizing fasciitis (LRINEC), and clinical outcomes were recorded and analyzed. Results A total of 19 patients diagnosed with NSTI were identified, including 6 deaths (31.6%) and 11 amputations (57.9%). The causes of injury included injuries by marine organism in 8 cases, animal bites in 5 cases, injuries by foreign body in 4 cases, and car accidents in 2 cases. There were 5 cases (26.3%) of type I (mixed microbial infection), 6 cases (31.6%) of type II (single bacterial infection, excluding Vibrio species), 7 cases (36.8%) of type III (Vibrio infection alone), and 1 case (5.3%) without culture results. There were 4 cases with LRINEC scores below 6, 10 cases with scores between 6 and 8, and 5 cases with scores above 8. The false negative rate was 21.1% (4/19). Among the deceased patients, 3 were infected with Vibrio vulnificus and 2 were mixed infection with multiple microorganisms, 1 was infected with single bacterial strains. Three cases of open limb injury were treated with vacuum sealing drainage after debridement. The vacuum sealing drainage was removed after more than 48 hours. Fascial necrosis was not detected early. Two patients were cured by amputation, while one patient died from amputation. The time from admission to initial surgery was 21.4 (2-72) hours. The length of stay in the intensive care unit (ICU) was 1.4 (0-7) days. The total length of hospital stay was 20.5 (2-58) days. Conclusions The incidence and mortality rate of Vibrio vulnificus are high in coastal areas. Early diagnosis and treatment are the most important means to improve the prognosis of patients with NSTI. The use of vacuum sealing drainage may delay early diagnosis of NSTI after open injury surgery. There are still some false negatives in the LRINEC score for NSTI screening, and caution should be taken against this situation.
  • Comparative efficacy of different antiretroviral therapy regimens initiated on the day of diagnosis in treatment-naive HIV/AIDS patients
    ZHANG Wei, LI Qisui, DENG Changgang, HUANG Wei, SUN Yanyu, YUAN Jing
    2026, 26(2): 124-129. https://doi.org/10.16718/j.1009-7708.2026.02.003
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    Objective To understand the efficacy of antiretroviral therapy (ART) initiated on the day of diagnosis in treatment-naive HIV/AIDS patients, and compare the virological suppression rate, treatment maintenance rate and maintenance rate of original ART regimen between different ART regimens. Methods Patients who initially treated with ART in Chongqing Public Health Medical Treatment Center from January 1, 2022 to December 31, 2022 were retrospectively identified. Their ART was initiated within 24 hours on the day of diagnosis. The patients were assigned to one of the following four group according to the ART regimen they received: three-drug combination (STR-3D), two-drug combination (STR-2D), or multi-drug combination (MTR1: 2NRTIs+NNRTIs, MTR2: 2NRTIs+LPV/r). Results A total of 163 treatment-naive HIV/AIDS patients were included in the study. Overall, 70.6% (115/163) of the patients were males, with a mean baseline age of (49.9±17.2) years and median CD4+ T lymphocytes count of 222.0 (136.0, 306.0) /μL. The median value of HIV RNA was 112 000 (46 700, 51 400) copies/mL. There were 105 (64.4%) patients in STR-3D group, 22 (13.5%) patients in STR-2D group, 34 (20.9%) patients in MTR1 group and 2 (1.2%) patients in MTR2 group. Only the first three ART regimens were statistically analyzed because the number of patient was too small in MTR2 group. The overall virologic suppression rate was 85.0% (113/133) at 24 weeks after ART-initiation in patients with viral load results, specifically 90.0% (81/90) in STR-3D group, 94.4% (17/18) in STR-2D group and 65.2% (15/23) in MTR1 group. Significant difference was found among the three groups (P = 0.011). The median increase of CD4+ T lymphocytes at 24 weeks was 106.5 (59.0, 185.3) cells/μL, of which the increase was 122.0 (64.0, 202.0) /μL in STR-3D group, 98.0 (49.5, 155.5)/μL in STR-2D group and 78.0 (8.0, 137.0) /μL in MTR1 group (P = 0.047). Among the patients with viral load results at 48 weeks of follow-up, the overall virological suppression rate was 97.7% (128/131), specifically 97.8% (88/90) in STR-3D group, 100% (13/13) in STR-2D group, and 96.2% (25/26) in MTR1 group (P = 0.664). At week 48, the median increase of CD4+ T lymphocytes was 144.5 (63.3, 234.8) /μL, specifically 148.5 (67.8, 241.0) /μL, 171.0 (63.5, 266.5) /μL, and 109.0 (46.0, 215.0) /μL in the three groups, respectively (P = 0.431). After 48 weeks of follow-up, the overall treatment maintenance rate was 91.4% (149/163). After excluding the 6 patients who died, the treatment maintenance rate was 98.0% (98/100) in STR-3D group, 90.9% (20/22) in STR-2D group, and 87.9% (29/33) in MTR1 group (P = 0.040). The overall maintenance rate of the original ART regimen within 48 weeks was 87.1% (142/163), and 94.3% (99/105), 77.3% (17/22), and 73.5% (25/34) in the three groups, respectively (P = 0.001). Conclusions The virological suppression rate, treatment maintenance rate and the maintenance rate of original ART regimen were high in treatment-naive HIV/AIDS patients who initiated ART on the same day of diagnosis. The early treatment effect of single-tablet ART was significantly better than that of multi-tablet ART. It is recommended to initiate single-tablet ART containing three drugs on the same day of diagnosis.
  • Risk factors for HIV infection among spouses/sexual partners of AIDS inpatients in Chongqing
    YU Qing, HUO Qin, ZHANG Wei, YUAN Jing
    2026, 26(2): 130-135. https://doi.org/10.16718/j.1009-7708.2026.02.004
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    Objective To identify the risk factors for HIV infection among spouses/sexual partners of in-patients living with HIV (PLWH) in Chongqing, China. Methods A cross-sectional study design was used to conduct a questionnaire-based survey on spouses/sexual partners of hospitalized AIDS patients from August 2021 to March 2023. Participants were stratified into two groups based on HIV co-infection status. Between-group comparisons were conducted using SPSS 27.0. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for HIV infection in this population. Results Overall, 200 spouses/sexual partners of hospitalized AIDS patients completed the survey, including 70 HIV-positive and 130 HIV-negative individuals. The overall infection rate was 35.0%. The HIV-negative group demonstrated significantly higher rates of consistent condom use during sexual intercourse (P < 0.05) and shorter time from infection onset to HIV status disclosure to spouses/sexual partners (<1 year, P < 0.05) and index patients who had initiated antiretroviral therapy (ART, P < 0.05) compared to the HIV-positive group. Conversely, the HIV-positive group had a significantly higher proportion of male participants (P < 0.05). Univariate analysis identified condom use, time from infection onset to HIV status disclosure to spouses/sexual partners, ART status, lacking knowledge of mother-to-child HIV transmission prevention, and poor awareness of pre-exposure prophylaxis, as risk factors significantly associated with HIV infection among spouses/sexual partners (all P < 0.05). Multivariate logistic regression analysis further revealed that unprotected sexual intercourse (OR = 6.734, 95% CI: 2.028-22.371) was an independent risk factor for HIV transmission. In contrast, female sex (OR = 0.240, 95% CI: 0.122-0.473) and ART initiation by the index patient (OR = 0.365, 95% CI: 0.189-0.704) were protective factors against HIV infection. Conclusions Spouses/sexual partners of hospitalized PLWH in Chongqing demonstrated poor awareness of HIV knowledge. Male partners, inconsistent condom use, and absence of ART in index patients significantly elevate the risk of HIV transmission to their spouses/sexual partners.
  • Predictive factors for plastic bronchitis in children with Mycoplasma pneumoniae pneumonia
    SHI Shuang, CHEN Ming, GU Haoxiang, JIANG Kun, CHE Dadian, DONG Xiaoyan
    2026, 26(2): 136-142. https://doi.org/10.16718/j.1009-7708.2026.02.005
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    Objective To explore the clinical characteristics and predictive factors for plastic bronchitis (PB) in children with Mycoplasma pneumoniae pneumonia (MPP). Methods We retrospectively collected the clinical data from 91 MPP patients with PB (PB group) and 258 MPP patients without PB (non-PB group) who underwent bronchoscopy treatment at Department of Respiratory Medicine, Shanghai Children's Hospital between 2020 and 2023. Comparative analyses were performed on clinical manifestations, laboratory tests, imaging characteristics, and treatment regimens between the two groups to identify predictive factors for PB development in children with MPP. Results Univariate analysis showed that PB group had higher incidene rate of hypoxemia, decreased respiratory sounds, pleural effusion, ≥2/3 lobe consolidation, and atelectasis, and longer duration of fever, and higher levels of neutrophil count, C-reactive protein, alanine aminotransferase, creatine kinase MB, lactate dehydrogenase, ferritin, D-dimer, fibrinogen degradation products (FDP), interferon-γ (IFN-γ), interleukin-1β (IL-1β), tumor necrosis factor α, immunoglobulin A, and immunoglobulin M, and the higher levels of IFN-γ, IL-8, TNF-α and MP-DNA in bronchialveolar lavage fluid than the control group (P < 0.05). Multivariate logistic regression analysis showed that ≥2/3 lobe consolidation (OR=8.707,P<0.001), FDP (OR=1.216, P=0.001), and IFN-γ (OR=1.004,P=0.019) were independent risk factors for the occurrence of PB in children with MPP. ROC curve analysis demonstrated that serum FDP has certain predictive value for PB occurrence in MPP (AUC=0.73). When combined with chest CT findings of ≥2/3 lobar consolidation and serum IFN-γ levels, the predictive performance significantly improved (AUC=0.85), showing superior clinical predictive potential. Conclusions Early chest CT showing ≥2/3 lobar consolidation along with elevated serum FDP and IFN-γ levels serve as important predictive indicators for PB development in pediatric MPP patients. PB often results in stronger inflammatory response, immune disorders, and hypercoagulability.
  • Correlation between serum levels of miR-15a-5p, miR-155-5p, miR-146a-5p and the severity and prognosis of severe pneumonia
    YANG Peixia, XU Hongbang
    2026, 26(2): 143-149. https://doi.org/10.16718/j.1009-7708.2026.02.006
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    Objective To investigate the correlation between serum levels of miR-15a-5p, miR-155-5p, miR-146a-5p and the severity and prognosis of severe pneumonia. Methods Sixty-five patients with severe pneumonia admitted to Linyi Central Hospital during the period from July 2022 to July 2024 were selected as the study group. Another 40 patients with non-severe pneumonia were assigned to the control group. Spearman method was used to analyze the correlation between serum miR-15a-5p, miR-155-5p, miR-146a-5p levels and clinical pulmonary infection score (CPIS) in patients with severe pneumonia. Logistic analyses were carried out to identify the factors affecting the prognosis of patients with severe pneumonia. Receiver operating characteristic (ROC) curve was applied to analyze the value of serum miR-15a-5p, miR-155-5p, and miR-146a-5p levels for predicting the prognosis of patients with severe pneumonia. Results Compared with patients with non-severe pneumonia, the patients with severe pneumonia had significantly higher miR-15a-5p, miR-155-5p levels and CPIS, and significantly lower miR-146a-5p level (P < 0.05). Serum miR-15a-5p and miR-155-5p levels in patients with severe pneumonia were positively correlated with CPIS (r = 0.320, 0.416, P < 0.05), while serum miR-146a-5p level was negatively correlated with CPIS (r = –0.386, P < 0.05). Compared with surviving patients, the patients who died from severe pneumonia had significantly higher serum levels of miR-15a-5p and miR-155-5p, and significantly lower miR-146a-5p level (P < 0.05). Serum levels of miR-15a-5p and miR-155-5p were risk factors for the poor outcomes of patients with severe pneumonia, while serum miR-146a-5p level was a protective factor for the prognosis of patients with severe pneumonia (OR=1.989, 3.816, 0.481, P < 0.05). The area under the ROC curve of serum miR-15a-5p, miR-155-5p, miR-146a-5p, and their combination in predicting the prognosis of severe pneumonia patients was 0.788 (95% CI: 0.672-0.905), 0.805(95% CI: 0.690-0.919), 0.817 (95% CI: 0.717-0.918), and 0.923 (95% CI: 0.861-0.985), respectively. The corresponding sensitivity of prediction was 73.33%, 76.67%, 73.33%, and 93.33%, respectively. The specificity of prediction was 82.86%, 85.71%, 80.00%, and 77.14%, respectively. The combination of miR-15a-5p, miR-155-5p, miR-146a-5p had significantly higher value for predicting the prognosis of severe pneumonia patients than the three biomarkers alone (Zcombination - miR-15a-5p = 2.296, P = 0.022; Zcombination - miR-155-5p =2.147, P = 0.032; Zcombination - miR-146a-5p = 2.234, P = 0.026). Conclusions The increased serum levels of miR-15a-5p and miR-155-5p, and the decreased miR-146a-5p level are associated with disease severity and poor outcomes of patients with severe pneumonia. The combination of the three biomarkers is more useful for predicting the prognosis of patients with severe pneumonia.
  • Diagnosis of leptospirosis by metagenomic next generation sequencing of bronchoalveolar lavage fluid: a case report and literature review
    ZHANG Ting, ZHOU Xiaolin, LIU Qiang, CHEN Yanyu, LIU Jia
    2026, 26(2): 150-154. https://doi.org/10.16718/j.1009-7708.2026.02.007
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    Objective To diagnose leptospirosis by metagenomic next generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF). Methods A retrospective analysis was performed on the clinical manifestations, laboratory findings, treatment, and outcome of one patient diagnosed with leptospirosis by mNGS of BALF. Relevant cases were identified by searching CNKI, VIP, Wanfang, Chinese Medical Association Journal Database and PubMed databases using the keywords “leptospirosis” and “metagenomic next-generation sequencing”. The clinical characteristics of leptospirosis and diagnosis and treatment methods were reviewed. Results The patient was admitted with complaints of “intermittent fever for more than one week and elevated serum creatinine for two days.” After admission, Leptospira was detected from BALF by mNGS. The patient was treated with penicillin-based antibiotic therapy for one week. The patient was discharged after improvement. Literature review showed that most patients presented with nonspecific symptoms such as fever, cough, sputum production, and fatigue. In some cases, mNGS of BALF detects potential pathogen in addition to Leptospira, making it necessary to clarify whether these are merely colonizing organisms or true mixed infections. Penicillin remained the primary antibiotic treatment. Conclusions The onset of leptospirosis is commonly characterized by fever and respiratory symptoms. However, its non-specific clinical presentation makes diagnosis and treatment relatively difficult. Molecular detection techniques can be used to identify the pathogen early, thereby improving patient prognosis.
  • The role of heparanase-mediated endothelial glycocalyx degradation in acute lung injury of septic mice
    LIN Xuerong, WANG Jia, SHEN Xiaoxing, WU Yanan, ZHANG Qiang, HAN Ying, XUE Qianlong
    2026, 26(2): 155-162. https://doi.org/10.16718/j.1009-7708.2026.02.008
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    Objective To explore the role of heparanase-mediated endothelial glycocalyx degradation in the pathophysiology of acute lung injury (ALI) in septic mice and evaluate the protective effects of heparanase inhibitors on ALI. Methods A septic mouse model was established using cecal ligation and puncture (CLP). The specific heparanase inhibitor PG545 was applied for intervention. Lung tissue pathological changes were assessed by HE staining. Transmission electron microscopy was used to observe the structural changes of the pulmonary microvascular endothelial glycocalyx. Western blot was performed to detect the expression of heparanase and related signaling pathway molecules. Wheat germ agglutinin (WGA) staining was utilized to examine the glycocalyx structure on the cell surface. High-performance liquid chromatography-mass spectrometry (HPLC-MS) was employed to detect heparan sulfate degradation products. ELISA was used to measure the levels of inflammatory cytokines and endothelial function-related markers. Results In CLP mice, heparanase expression in lung tissue was significantly upregulated, leading to severe damage to the endothelial glycocalyx structure, increased alveolar-capillary membrane permeability, and exacerbated inflammatory responses. PG545 intervention effectively inhibited heparanase activity, reduced endothelial glycocalyx injury, decreased inflammatory reactions, and improved lung tissue pathological damage. Mechanistic studies revealed that heparanase promotes the release of inflammatory cytokines by activating the NF-κB pathway and disrupts endothelial barrier function by inducing endothelial cytoskeletal remodeling. Conclusions Heparanase-mediated endothelial glycocalyx degradation is a key pathological mechanism in sepsis-induced acute lung injury. The heparanase inhibitor PG545 exerts significant protective effects on sepsis-associated acute lung injury by preserving the integrity of the endothelial glycocalyx, reducing the increase of lung vascular permeability, and attenuating inflammatory responses, thus providing a new potential target for clinical treatment of sepsis-related acute lung injury.
  • Surveillance of antimicrobial resistance among the bacterial isolates in Xinjiang Region in 2023
    CHEN Na, RENAGU Aishan, JI Ping
    2026, 26(2): 163-172. https://doi.org/10.16718/j.1009-7708.2026.02.009
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    Objective To understand the distribution and antimicrobial resistance profiles of bacterial strains isolated from patients in Xinjiang region. Method According to the unified technical protocol of China Antimicrobial Resistance Surveillance System, antimicrobial susceptibility testing was performed by using automated systems, disk diffusion method, or E-test strip method. The results were interpreted according to the 2023 Clinical and Laboratory Standards Institute breakpoints. The data were analyzed using WHONET 5.6 software. Results A total of 120 530 bacterial isolates were collected, of which Gram positive and Gram negative bacteria accounted for 28.6% and 71.4%, respectively. Overall, 3.4% and 96.6% of the strains were isolated from outpatients and inpatients, respectively. The top three common specimens for isolation of the bacterial strains were respiratory tract specimens, urine specimens, and wound pus secretion specimens. The top five common bacterial species were Escherichia coli, Klebsiella spp., Staphylococcus aureus, Acinetobacter spp., and Enterococcus spp.. The prevalence of MRSA and MRCNS in tertiary hospitals were higher than those in secondary hospitals. No vancomycin- or teicoplanin-resistant strains were found. Enterococcus isolates showed low level resistance rates to vancomycin, teicoplanin, and linezolid. The prevalence of carbapenem-resistant E. coli and carbapenem-resistant K. pneumoniae were 0.7% and 1.7% in secondary hospitals, 0.9% and 11.0% in tertiary hospitals, respectively. Conclusions The bacterial isolates in tertiary hospitals showed higher resistance rate to most antibiotics and higher prevalence of multidrug-resistant bacteria than the isolates in secondary hospitals. Ongoing surveillance of antimicrobial resistance profiles in the clinical isolates in local hospitals can inform rational antibiotic use and curb bacterial resistance.
  • Pathogen profiles of lower respiratory tract infections in Pediatric Department of Yichun People’s Hospital in 2024 and 2025
    XU Rong, HUANG Bo, LEI Meng, XU Ye, LI Na, ZHANG Xiaolian
    2026, 26(2): 173-178. https://doi.org/10.16718/j.1009-7708.2026.02.010
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    Objective To establish an age-stratified pathogen distribution profile of pediatric lower respiratory tract infections (LRTIs) in Yichun City during 2024-2025, supporting evidence-based antibiotic stewardship. Methods A total of 326 hospitalized pediatric patients with LRTIs were enrolled in Yichun People’s Hospital, including 196 infants (<3 years) and 130 children (3-13 years). Sputum samples were collected on admission for conducting conventional bacterial culture, nucleic acid assays for atypical pathogen and Mycobacterium tuberculosis, and multiplex PCR for respiratory viruses. Results The pathogen positive rate was 74.8%. The viral positive rate (53.7%) was higher than that of bacteria (35.0%). Haemophilus influenzae (12.6%), Moraxella catarrhalis (8.3%), and Streptococcus pneumoniae (7.4%) were the predominant species among the bacteria identified from conventional culture. Among atypical pathogens, M. pneumoniae had the highest positive rate (11.0%). Among viruses, human rhinovirus (16.0%), adenovirus (13.5%), and respiratory syncytial virus (12.6%) had the highest positive rates. Age-stratified analysis showed that bacterial positive rate (44.4%) and viral positive rate (63.8%) were higher in infant (<3 years) group, particularly for S. pneumoniae, K. pneumoniae and respiratory syncytial virus; while in the pediatric (3-13 years) group, atypical pathogens (such as M. pneumoniae, 22.3%) and influenza A virus (15.4%) were more prominent. The rate of pathogen co-detection reached 31.9%, primarily bacterial-viral mixed infections (24.8%). H. influenzae and respiratory syncytial virus/adenovirus mixed infections were the most common (2.1%) pattern. Conclusions The distribution of pathogens in pediatric LRTIs in Yichun City shows obvious regional characteristics, mainly consisting of H. influenzae, M. pneumoniae, and human rhinovirus. Virus-bacteria co-detection is relatively common. The distribution of pathogens in LRTIs was significantly different between infants and children.
  • Changing carbapenem resistance profiles of Klebsiella pneumoniae: surveillance report from China Antimicrobial Resistance Surveillance System, 2020-2024
    China Antimicrobial Resistance Surveillance System
    2026, 26(2): 179-185. https://doi.org/10.16718/j.1009-7708.2026.02.011
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    Objective To investigate the changing carbapenem resistance profiles of Klebsiella pneumoniae in China hospitals from 2020 to 2024. Methods Antimicrobial susceptibility testing was performed using disk diffusion method, E-test, or commercial automated testing instruments such as VITEK-2 Compact according to China Antimicrobial Resistance Surveillance System (CARSS) protocol. The susceptibility testing results were interpreted against the standards of the Clinical and Laboratory Standards Institute (CLSI). WHONET 5.6 software was used to analyze the prevalence and susceptibility data of carbapenem resistant K. pneumoniae (CRKP). Results From 2020 to 2024, a total of 393 406 strains of CRKP were isolated. Overall, CRKP strains showed consistently high resistance rates (≥86.4%) to cephalosporins and quinolones, and relatively low resistance rate to tigecycline (≤13.5%), but with an increasing trend over the five-year period. The overall prevalence of CRKP decreased from 10.9% in 2020 to 10.0% in 2024. The prevalence of CRKP varied with region. In 2024, Shanghai and Beijing reported the highest prevalence (24.1% and 26.5%, respectively), whereas the lowest prevalence was observed in Ningxia Hui Autonomous Region and Qinghai Province (0.8% and 0.9%). CRKP prevalence (29.0%, 34.0%, 30.9%, 33.8%, and 37.6% from 2020 to 2024) was significantly higher in the strains isolated from cerebrospinal fluid samples compared to other specimen types. CRKP prevalence (21.1%, 21.0%, 18.2%, 21.7%, and 18.6% from 2020 to 2024) in the strains isolated from intensive care units was the highest among different clinical settings. Among different hospitals, children’s hospitals were associated with the highest CRKP prevalence from 2020 to 2022 (13.6%, 13.1%, and 10.8%), while tertiary general hospitals showed the highest CRKP prevalence in 2023 and 2024 (11.7% and 10.9%). Among different age groups, neonates had the highest CRKP prevalence in 2020 and 2021 (15.0% and 13.4%), whereas elderly patients showed the highest prevalence from 2022 to 2024 (11.4%, 12.3%, and 11.3%). Conclusions The overall prevalence of CRKP decreased from 2020 to 2024 in China hospitals. However, the prevalence varied greatly with year, region, specimen type, clinical setting, hospital type, and age group, underscoring the need for ongoing surveillance of CRKP.
  • Antimicrobial resistance profiles of the bacteria isolated from outpatients: surveillance report from China Antimicrobial Resistance Surveillance System, 2020-2024
    China Antimicrobial Resistance Surveillance System
    2026, 26(2): 186-195. https://doi.org/10.16718/j.1009-7708.2026.02.012
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    Objective To analyze the distribution and antimicrobial susceptibility of the bacterial strains isolated from outpatients in hospitals across China from 2020 to 2024. Methods According to China Antimicrobial Resistance Surveillance System (CARSS) technical protocol, bacterial isolates were identified using automated systems or manual methods. Antimicrobial susceptibility testing was conducted using disk diffusion method and automated systems. The susceptibility testing results were interpreted according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. WHONET 5.6 software was used to analyze the distribution of bacterial isolates and antimicrobial susceptibility testing results reported by all CARSS member hospitals in 2020-2024. Results Overall, 569 924 strains of bacteria were isolated from outpatients during the period from 2020 to 2024. Gram-positive bacteria accounted for 38.1%, and gram-negative bacteria accounted for 61.9%. The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) from 2020 to 2024 was 25.1%, 24.0%, 23.9%, 23.8% and 23.3%, respectively. The corresponding prevalence of methicillin-resistant coagulase-negative Staphylococcus (MRCNS) was 66.1%, 68.0%, 65.6%, 63.3% and 62.7%, respectively. MRSA and MRCNS strains showed higher resistance rates to most antimicrobial agents than methicillin susceptible strains. Enterococcus faecalis showed lower resistance rates to most antimicrobial agents tested than Enterococcus faecium. Vancomycin-, teicoplanin- and linezolid-resistant strains were identified in both E. faecalis and E. faecium. From 2020 to 2024, the prevalence of penicillin-resistant Streptococcus pneumoniae strains isolated from non-cerebrospinal fluid specimens was 0.3%, 0.6%, 0.7%,1.0% and 0.8%, respectively. The prevalence of imipenem-resistant Pseudomonas aeruginosa was 10.5%, 10.1%, 9.4%,10.4% and 10.5%, respectively. The prevalence of imipenem-resistant Acinetobacter baumannii was 36.5%, 38.3%, 35.4%, 36.7% and 40.3%, respectively. The prevalence of ceftriaxone-resistant Escherichia coli was 47.3%, 44.5%, 44.0%, 44.7% and 44.1%, respectively. The prevalence of imipenem-resistant E. coli was 0.7%, 0.7%, 0.8%, 0.8% and 0.8%, respectively. The prevalence of ceftriaxone-resistant Klebsiella pneumoniae was 28.8%, 27.5%, 26.8%, 28.9% and 29.5%, respectively. The prevalence of imipenem-resistant K. pneumoniae was 6.0%, 6.3%, 6.1%, 6.7% and 6.9%, respectively. From 2020 to 2024, the prevalence of ampicillin-resistant Haemophilus influenzae was 44.5%, 60.7%, 68.5%, 69.3% and 79.5%, respectively. Conclusions Antimicrobial resistance of the bacterial strains isolated from outpatients is still serious, especially multidrug-resistant Gram-negative bacilli and methicillin-resistant Staphylococcus.
  • Antimicrobial resistance profiles of bacteria isolated from cerebrospinal fluid: surveillance report from China Antimicrobial Resistance Surveillance System, 2020-2024
    China Antimicrobial Resistance Surveillance System
    2026, 26(2): 196-205. https://doi.org/10.16718/j.1009-7708.2026.02.013
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    Objective To investigate the distribution and antimicrobial resistance profiles of the bacterial strains isolated from cerebrospinal fluid (CSF) in hospitals across China from 2020 to 2024. Methods The data on bacterial identification and antimicrobial susceptibility testing of the bacterial strains isolated from CSF specimens in about 2 000 member hospitals from 2020 to 2024 were collected and analyzed in accordance with the China Antimicrobial Resistance Surveillance System technical protocol. Results A total of 96 234 bacterial strains were isolated from 2020 to 2024, of which 71.7% were Gram positive and 28.3% were Gram negative. The top 6 organisms were coagulase-negative Staphylococcus, Acinetobacter spp., Enterococcus spp., Klebsiella spp., Escherichia coli, and Staphylococcus aureus. The prevalence of methicillin-resistant S. aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus (MRCNS) was stable at approximately 40% and 70%, respectively. The prevalence of vancomycin-resistant E. faecium increased from 3.2% in 2020 to 6.5% in 2024, while the prevalence of vancomycin-resistant E. faecalis was consistent at a low level of about 0.2%. The prevalence of penicillin-resistant S. pneumoniae increased from 71.2% to 76.9%. The prevalence of meropenem-resistant K. pneumoniae, A. baumannii and P. aeruginosa increased from 29.3%, 69.8%, and 24.3% to 39.1%, 74.6%, and 29.2%, respectively, while the prevalence of meropenem-resistant E. coli tended to be stable at approximately 4%. Conclusions Coagulase-negative Staphylococcus was predominant among the clinical isolates from CNS in China. Meropenem-resistant K. pneumoniae, A. baumannii, and P. aeruginosa are still highly prevalent. Ongoing bacterial resistance surveillance is essential for rational use of antibiotics in clinical practice and informing adequate control measures.
    • Case Report
  • Chronic brucellosis-induced femoral osteomyelitis complicated with skin sinus tract formation: a case report
    WANG Xiaohui, WEN Hainan, LIANG Yueyi, LIU Yanchao, SUN Lihong, YANG Sixi, XIE Shoujun
    2026, 26(2): 206-208. https://doi.org/10.16718/j.1009-7708.2026.02.014
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  • A case of postoperative Mycoplasma hominis infection after bone arthroplasty
    LI Caihua, GONG Ping, QIAO Wei, WU Hongyan, CHEN Xin, LI Xuelan
    2026, 26(2): 209-212. https://doi.org/10.16718/j.1009-7708.2026.02.015
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  • Meningitis caused by Bartonella henselae in an adult: a case report
    WU Zhengju, LI Xingyu, XIAO Ke
    2026, 26(2): 213-214. https://doi.org/10.16718/j.1009-7708.2026.02.016
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