Yong-Li Wan, Tao Han, Qiang Sun, Donghao Wang, Jun Li, Li-Jie Wang, Min Peng, Yin Li, Qing-Guo Feng, Chun-Guang Liu, Jie Xu, Bin Bao, Mei Su, Zhi-Yong Fei, Xu-Liang Wang, Xiao-Bo Liu
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引用次数: 0
Abstract
Objective: To evaluate microbial distribution and antimicrobial resistance (AMR) patterns in clinical isolates from 13 tertiary hospitals and one secondary hospital in Tianjin (2021-2023) to inform precision-driven antimicrobial stewardship and infection control interventions.
Methods: In this retrospective, multicenter study, we collected routine diagnostic specimens-including sputum, fecal samples, secretions, blood, and drainage fluids. Data were processed per standardized protocols (CARSS, CHINET) and interpreted using current CLSI-M100 breakpoints. Statistical analyses were performed with SPSS 20.0 (significance set at two-tailed P < 0.05).
Results: Sputum specimens increased from 39.1% to 43.0%, while urine samples and secretions declined. Klebsiella pneumoniae prevalence rose from 18.3% to 20.3%, whereas Escherichia coli remained stable. E. coli maintained excellent susceptibility to carbapenems and amikacin (≤2% resistance); notably, ceftazidime/avibactam resistance declined from 7.2% to 3.4% (P = 0.005) amid a significant increase in cefepime resistance (24.4% to 29.6%, P < 0.001). K. pneumoniae exhibited parallel trends, with escalating resistance to β-lactam/β-lactamase inhibitor agents. In Pseudomonas aeruginosa, aminoglycoside, and carbapenem profiles remained stable, while ceftazidime/avibactam sensitivity markedly improved, suggesting shifts in underlying resistance mechanisms. Acinetobacter baumannii showed enhanced susceptibility to aminoglycosides, β-lactam inhibitors, and fluoroquinolones; however, carbapenem-resistant isolates continued to exhibit near-universal resistance. Among gram-positive pathogens, methicillin-resistant Staphylococcus aureus sustained near-universal β-lactam resistance with improved rifampicin sensitivity, while glycopeptides and linezolid remained fully active. Enterococcus faecalis demonstrated reduced ampicillin resistance, contrasting with E. faecium's near-pan-resistance to β-lactams and fluoroquinolones.
Conclusion: Evolving, species-specific AMR patterns in Tianjin hospitals highlight the urgent need for real-time, regionally stratified surveillance and molecularly informed stewardship strategies to guide targeted antimicrobial interventions and improve clinical outcomes.
期刊介绍：
Frontiers in Cellular and Infection Microbiology is a leading specialty journal, publishing rigorously peer-reviewed research across all pathogenic microorganisms and their interaction with their hosts. Chief Editor Yousef Abu Kwaik, University of Louisville is supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
Frontiers in Cellular and Infection Microbiology includes research on bacteria, fungi, parasites, viruses, endosymbionts, prions and all microbial pathogens as well as the microbiota and its effect on health and disease in various hosts. The research approaches include molecular microbiology, cellular microbiology, gene regulation, proteomics, signal transduction, pathogenic evolution, genomics, structural biology, and virulence factors as well as model hosts. Areas of research to counteract infectious agents by the host include the host innate and adaptive immune responses as well as metabolic restrictions to various pathogenic microorganisms, vaccine design and development against various pathogenic microorganisms, and the mechanisms of antibiotic resistance and its countermeasures.
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