AI Xiaoman, HU Yunjian, GE Chunyue, YANG Yang, HU Fupin, ZHU Demei, XU Yingchun, ZHANG Xiaojiang, LI Hui, JI Ping, XIE Yi, KANG Mei, WANG Chuanqing, FU Pan, XU Yuanhong, HUANG Ying, SUN Ziyong, CHEN Zhongju, NI Yuxing, SUN Jingyong, CHU Yunzhuo, TIAN Sufei, HU Zhidong, LI Jin, YU Yunsong, LIN Jie, SHAN Bin, DU Yan, GUO Sufang, WEI Lianhua, ZOU Fengmei, ZHANG Hong, WANG Chun, ZHUO Chao, SU Danhong, GUO Dawen, ZHAO Jinying, YU Hua, HUANG Xiangning, LIU Wen'en, LI Yanming, JIN Yan, SHAO Chunhong, XU Xuesong, YAN Chao, WANG Shanmei, CHU Yafei, ZHANG Lixia, MA Juan, ZHOU Shuping, ZHOU Yan, ZHU Lei, MENG Jinhua, DONG Fang, LÜ Zhiyong, HU Fangfang, SHEN Han, ZHOU Wanqing, JIA Wei, LI Gang, WU Jinsong, LU Yuemei, LI Jihong, DUAN Jinju, KANG Jianbang, MA Xiaobo, ZHENG Yanping, GUO Ruyi, ZHU Yan, CHEN Yunsheng, MENG Qing, WANG Shifu, HU Xuefei, SHEN Jilu, HUANG Wenhui, WANG Ruizhong, FANG Hua, YU Bixia, ZHAO Yong, GONG Ping, WENG Kaizhen, ZHANG Yirong, LIU Jiangshan, LIAO Longfeng, GU Hongqin, JIANG Lin, HE Wen, XUE Shunhong, FENG Jiao, YUE Chunlei
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Objective To investigate the antimicrobial resistance of clinical isolates from elderly patients (≥65 years) in major medical institutions across China. Methods Bacterial strains were isolated from elderly patients in 52 hospitals participating in the CHINET Antimicrobial Resistance Surveillance Program during the period from 2015 to 2021. Antimicrobial susceptibility test was carried out by disk diffusion method and automated systems according to the same CHINET protocol. The data were interpreted in accordance with the breakpoints recommended by the Clinical and Laboratory Standards Institute (CLSI) in 2021. Results A total of 514 715 nonduplicate clinical isolates were collected from elderly patients in 52 hospitals from January 1, 2015 to December 31, 2021. The number of isolates accounted for 34.3% of the total number of clinical isolates from all patients. Overall, 21.8% of the 514 715 strains were gram-positive bacteria, and 78.2% were gram-negative bacteria. Majority (90.9%) of the strains were isolated from inpatients. About 42.9% of the strains were isolated from respiratory specimens, and 22.9% were isolated from urine. More than half (60.7%) of the strains were isolated from male patients, and 39.3% isolated from females. About 51.1% of the strains were isolated from patients aged 65-<75 years. The prevalence of methicillin-resistant strains (MRSA) was 38.8% in 32 190 strains of Staphylococcus aureus. No vancomycin- or linezolid-resistant strains were found. The resistance rate of E. faecalis to most antibiotics was significantly lower than that of Enterococcus faecium, but a few vancomycin-resistant strains (0.2%, 1.5%) and linezolid-resistant strains (3.4%, 0.3%) were found in E. faecalis and E. faecium. The prevalence of penicillin-susceptible S. pneumoniae (PSSP), penicillin-intermediate S. pneumoniae (PISP), and penicillin-resistant S. pneumoniae (PRSP) was 94.3%, 4.0%, and 1.7% in nonmeningitis S. pneumoniae isolates. The resistance rates of Klebsiella spp. (Klebsiella pneumoniae 93.2%) to imipenem and meropenem were 20.9% and 22.3%, respectively. Other Enterobacterales species were highly sensitive to carbapenem antibiotics. Only 1.7%-7.8% of other Enterobacterales strains were resistant to carbapenems. The resistance rates of Acinetobacter spp. (Acinetobacter baumannii 90.6%) to imipenem and meropenem were 68.4% and 70.6% respectively, while 28.5% and 24.3% of P. aeruginosa strains were resistant to imipenem and meropenem, respectively. Conclusions The number of clinical isolates from elderly patients is increasing year by year, especially in the 65-<75 age group. Respiratory tract isolates were more prevalent in male elderly patients, and urinary tract isolates were more prevalent in female elderly patients. Klebsiella isolates were increasingly resistant to multiple antimicrobial agents, especially carbapenems. Antimicrobial resistance surveillance is helpful for accurate empirical antimicrobial therapy in elderly patients.
