FU Ying, YU Yunsong, LIN Jie, YANG Yang, HU Fupin, ZHU Demei, XU Yingchun, ZHANG Xiaojiang, ZHANG Fengbo, 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, SHAN Bin, DU Yan, GUO Sufang, WEI Lianhua, ZOU Fengmei, ZHANG Hong, WANG Chun, HU Yunjian, AI Xiaoman, 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, 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, HUANG Wenhui
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Objective To characterize the changing species distribution and antibiotic resistance profiles of respiratory isolates in hospitals participating in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021. Methods Commercial automated antimicrobial susceptibility testing systems and disk diffusion method were used to test the susceptibility of respiratory bacterial isolates to antimicrobial agents following the standardized technical protocol established by the CHINET program. Results A total of 589 746 respiratory isolates were collected from 2015 to 2021. Overall, 82.6% of the isolates were Gram-negative bacteria and 17.4% were Gram-positive bacteria. The bacterial isolates from outpatients and inpatients accounted for (6.0 ± 0.9)% and (94.0 ± 0.1)%, respectively. The top microorganisms were Klebsiella spp., Acinetobacter spp., Pseudomonas aeruginosa, Staphylococcus aureus, Haemophilus spp., Stenotrophomonas maltophilia, Escherichia coli, and Streptococcus pneumoniae. Each microorganism was isolated from significantly more males than from females (P < 0.05). The overall prevalence of methicillin-resistant S. aureus (MRSA) was 39.9%. The prevalence of penicillin-resistant S. pneumoniae was 1.4%. The prevalence of extended-spectrum β-lactamase (ESBL)-producing E. coli and K. pneumoniae was 67.8% and 41.3%, respectively. The overall prevalence of carbapenem-resistant E. coli, K. pneumoniae, Enterobacter cloacae, Pseudomonas aeruginosa, and Acinetobacter baumannii was 3.7%, 20.8%, 9.4%, 29.8%, and 73.3%, respectively. The prevalence of β-lactamase was 96.1% in Moraxella catarrhalis and 60.0% in Haemophilus influenzae. The H. influenzae isolates from children (<18 years) showed significantly higher resistance rates to β-lactam antibiotics than the isolates from adults (P < 0.05). Conclusions Gram-negative bacteria are still predominant in respiratory isolates associated with serious antibiotic resistance. Antimicrobial resistance surveillance should be strengthened in clinical practice to support accurate etiological diagnosis and appropriate antimicrobial therapy based on antimicrobial susceptibility testing results.
