Hou Bailong, Niu Xiaoqin, Yu Qinlong, Wang Wei
Department of Clinical Laboratory, The First Hospital of Jiaxing, The Affiliated Hospital of Jiaxing University, Jiaxing, 314000, People's Republic of China.
Infect Drug Resist. 2025 Jun 5;18:2867-2880. doi: 10.2147/IDR.S518461. eCollection 2025.
To elucidate the distribution characteristics and drug resistance of carbapenem-resistant gram-negative bacteria (CR-GNB) within a general hospital setting from 2019 to 2024.
The distribution characteristics of CR-GNB and antimicrobial resistance patterns among inpatients from 2019 to 2024 were investigated. The detection rate, departmental distribution, annual trends, and drug susceptibility profiles of key carbapenem-resistant bacterial species were compared.
A total of 34, 370 patients infected with GNB were investigated, with 2967 cases identified as CR-GNB. Among these, the nosocomial infection rate of carbapenem-resistant (CRE), carbapenem-resistant (CRAB), and carbapenem-resistant (CRPA) were 33.11%, 44.02%, and 22.87%, respectively. The positivity rate for CR-GNB among male patients was 72.94%, with the vast majority of these infected patients (71.88%) aged 65 and above. In 2021, notable shifts in hospital infection control concerning CR-GNB were observed, with a reduction of over 40% in CRAB infection rates and a decline of over 35% in CRPA infection rates. The top three clinical departments with CR-GNB detection were the intensive care unit (ICU), intensive rehabilitation ward (HDU), and emergency ward. CR-GNB accounted for the largest proportion of respiratory infections (73.49%). Clinically isolated CR-GNB exhibited pan-resistance to commonly used clinical antimicrobial drugs, with only cefoperazone/sulbactam, amikacin, and tigecycline demonstrating high sensitivity. Analysis of carbapenemase production revealed a significant prevalence of Ambler class A enzymes.
The detection of CR-GNB in this hospital from 2019 to 2024 indicates a widespread distribution across clinical departments and infection sites, coupled with a high rate of resistance to commonly used antimicrobials. Local hospitals should prioritize the distribution patterns of CR-GNB to develop personalized prevention strategies, strengthen hospital public health and infection prevention and control measures, and promote rational use of antibiotics to effectively curb the spread of CR-GNB infections.
阐明2019年至2024年综合医院环境中耐碳青霉烯类革兰阴性菌（CR-GNB）的分布特征及耐药情况。
调查2019年至2024年住院患者中CR-GNB的分布特征及抗菌药物耐药模式。比较关键耐碳青霉烯类细菌物种的检出率、科室分布、年度趋势及药敏谱。
共调查34370例革兰阴性菌感染患者，其中2967例为CR-GNB。其中，耐碳青霉烯类肠杆菌科细菌（CRE）、耐碳青霉烯类鲍曼不动杆菌（CRAB）和耐碳青霉烯类铜绿假单胞菌（CRPA）的医院感染率分别为33.11%、44.02%和22.87%。男性患者中CR-GNB阳性率为72.94%，这些感染患者绝大多数（71.88%）年龄在65岁及以上。2021年，观察到医院感染控制方面关于CR-GNB的显著变化，CRAB感染率下降超过40%，CRPA感染率下降超过35%。CR-GNB检出率最高的前三个临床科室是重症监护病房（ICU）、强化康复病房（HDU）和急诊科。CR-GNB在呼吸道感染中占比最大（73.49%）。临床分离的CR-GNB对常用临床抗菌药物呈现泛耐药，仅头孢哌酮/舒巴坦、阿米卡星和替加环素显示高敏感性。碳青霉烯酶产生情况分析显示Ambler A类酶显著流行。
该医院在2019年至2024年对CR-GNB的检测表明其在临床科室和感染部位广泛分布，且对常用抗菌药物耐药率高。当地医院应优先关注CR-GNB的分布模式以制定个性化预防策略，加强医院公共卫生和感染预防控制措施，并促进抗生素合理使用，以有效遏制CR-GNB感染的传播。
