Distribution and Antimicrobial Resistance Analysis of Blood Culture Isolates at a Chinese National Cardiovascular Regional Medical Center: A 7-Year Retrospective Study.

PURPOSE

This study aimed to characterize the epidemiological patterns and antimicrobial resistance profiles of bloodstream infections (BSIs) in a cardiovascular specialty hospital and to identify region-specific pathogen distributions, resistance risks, and clinical implications for optimizing empirical therapy and infection control strategies.

PATIENTS AND METHODS

A retrospective analysis (2018-2024) evaluated 1,055 non-duplicate BSI isolates from 37,576 blood cultures at the Fuwai Central China Cardiovascular Hospital. Researchers investigated both bacterial classification and associated drug resistance through comprehensive analysis.

RESULTS

The study revealed that a total of 1,055 bacterial strains were isolated from blood cultures, with Gram-negative bacteria accounting for 31.5% (332 strains), Gram-positive bacteria for 62.7% (662 strains), and fungi for 5.8% (61 strains). The most frequently isolated pathogens were (13.7%), inis (8.0%), (7.4%), (7.1%), and (6.7%). These pathogens were predominantly isolated from intensive care units (ICUs), with the Coronary Heart Disease ICU (24.7%), General ICU (18.0%), and Adult Cardiac Surgery ICU (8.1%) representing the top three departments for bacterial detection. Among isolates, methicillin-resistant (MRSA) and methicillin-resistant coagulase-negative (MRCNS) were identified at rates of 51.6% and 88.7%, respectively. The carbapenem resistance rates of and were 28.8% and 4.0%, respectively. Non-fermenting Gram-negative bacilli, such as , showed alarming resistance rates to carbapenems (60.0%) and other β-lactams (≥52%), while and remained highly susceptible to first-line agents.

CONCLUSION

Blood culture isolates in our hospital demonstrated a predominance of Gram-positive organisms, with high detection rates of MRSA, MRCNS, and carbapenem-resistant Gram-negative bacilli. Continuous antimicrobial resistance surveillance of bloodstream isolates should be maintained in clinical practice to provide evidence-based data for rational antibiotic use and mitigate the emergence of resistant pathogens.