Yuan Qiao, Zhu Weimin, Yuan Zhe, Zeng Qianqian
Department of Hospital Infection Control, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
Sci Rep. 2025 Aug 26;15(1):31381. doi: 10.1038/s41598-025-16957-8.
Antimicrobial resistance has been a major global threat to public health with the emergence of multidrug-resistant bacteria. We investigated the temporal trends in antimicrobial resistance and explored the relationships between antimicrobial consumption in hospitals and hospital-acquired bacterial resistance in four sub-hospitals of a large tertiary hospital in Chongqing from 2017 to 2023. The proportion of targeted isolates ranged from 52.4% (5119/9762) to 68.3% (4231/6198). Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa resistant to piperacillin/tazobactam and cefepime increased. Additionally, Acinetobacter baumannii resistant to β-lactam combination agents and carbapenems also increased. The same trends were found in oxacillin-resistant Staphylococcus aureus and linezolid-resistant Enterococcus faecium and linezolid-resistant Enterococcus faecalis. The isolation rates of hospital-acquired carbapenem-resistant Escherichia coli, carbapenem-resistant Klebsiella pneumoniae, carbapenem-resistant Pseudomonas aeruginosa and carbapenem-resistant Acinetobacter baumannii exhibited a positive correlation with the consumption of β-lactam combination agents and quinolones. The isolation rates of hospital-acquired methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus faecium were positively correlated with the consumption of third-generation cephalosporins excluding combinations with β-lactamase inhibitors. The isolation rate of hospital-acquired vancomycin-resistant Enterococcus faecalis was positively correlated with the consumption of cephamycins. Antimicrobial consumption in hospitals was positively correlated with the isolation rates of targeted hospital-acquired multidrug-resistant bacteria.
随着多重耐药菌的出现,抗菌药物耐药性已成为全球公共卫生的重大威胁。我们调查了2017年至2023年重庆一家大型三级医院的四家分院抗菌药物耐药性的时间趋势,并探讨了医院抗菌药物消费与医院获得性细菌耐药性之间的关系。目标分离株的比例从52.4%(5119/9762)到68.3%(4231/6198)不等。对哌拉西林/他唑巴坦和头孢吡肟耐药的大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌有所增加。此外,对β-内酰胺类联合制剂和碳青霉烯类耐药的鲍曼不动杆菌也有所增加。耐苯唑西林金黄色葡萄球菌、耐利奈唑胺粪肠球菌和耐利奈唑胺屎肠球菌也出现了同样的趋势。医院获得性耐碳青霉烯类大肠埃希菌、耐碳青霉烯类肺炎克雷伯菌、耐碳青霉烯类铜绿假单胞菌和耐碳青霉烯类鲍曼不动杆菌的分离率与β-内酰胺类联合制剂和喹诺酮类药物的消费量呈正相关。医院获得性耐甲氧西林金黄色葡萄球菌和耐万古霉素粪肠球菌的分离率与不包括与β-内酰胺酶抑制剂联合使用的第三代头孢菌素的消费量呈正相关。医院获得性耐万古霉素屎肠球菌的分离率与头孢霉素的消费量呈正相关。医院抗菌药物消费与目标医院获得性多重耐药菌的分离率呈正相关。