Bailong Hou, Xiaoqin Niu, Qinlong Yu, Wei Wang

Department of Clinical Laboratory, The First Hospital of Jiaxing, The Affiliated Hospital of Jiaxing University, Jiaxing, 314000, People’s Republic of China

Correspondence: Wei Wang, Department of Clinical Laboratory, The First Hospital of Jiaxing, The Affiliated Hospital of Jiaxing University, Jiaxing, 314000, People’s Republic of China, Email wxp594549048@163.com

Objective: 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.
Methods: 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.
Results: 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 Enterobacteriaceae (CRE), carbapenem-resistant Acinetobacter baumannii (CRAB), and carbapenem-resistant Pseudomonas aeruginosa (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.
Conclusion: 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.

Keywords: carbapenem-resistant gram-negative bacteria, epidemiology, drug resistance