Abstract
OBJECTIVE: This study aimed to analyze the distribution characteristics and dynamic trends of antimicrobial resistance among pathogens isolated from blood cultures of adult patients at a large tertiary hospital in southern Jiangxi Province, China, from 2020 to 2024, in order to provide evidence-based guidance for the prevention and treatment of bloodstream infections. METHODS: This study conducted a retrospective analysis of non-repetitive isolates from blood cultures of adult patients at a large tertiary hospital in southern Jiangxi Province between 2020 and 2024. Statistical analysis was performed using WHONET 5.6 and SPSS Statistics 30 software. RESULTS: This study included a total of 3,695 pathogenic bacteria, with Gram-negative bacteria predominating (61.92%,2,288/3,695). Among Gram-negative bacteria, Escherichia coli (28.99%,1,071/3,695) and Klebsiella pneumoniae (14.72%,544/3,695) were the most prevalent. Antimicrobial resistance analysis revealed that the detection rate of carbapenem-resistant Klebsiella pneumoniae (CRKP) surged sharply from 1.2% (1/82) in 2020 to 21.8% (26/119) in 2024; the detection rate of carbapenem-resistant Acinetobacter baumannii (CRAB) increased from 33.3%(5/15) in 2020 to 76.5% (13/17) in 2024. In contrast, the detection rate of methicillin-resistant Staphylococcus aureus (MRSA) decreased significantly from 24.3% (17/73) in 2020 to 13.5% (10/74) in 2024. Among Enterococci, the rate of high-level gentamicin resistance (HLGR, defined as resistance to 500 µg/ml gentamicin) in Enterococcus faecium increased significantly, from 10% (1/10) in 2020 to 66.7% (14/21) in 2024, and vancomycin-resistant Enterococcus faecium (VREfm) was detected at a rate of 9.5% (2/21) in 2024. CONCLUSION: In a tertiary hospital in southern Jiangxi, China, Gram-negative bacteria predominate among Patients with positive blood cultures, with sharply rising detection rates of CRKP, CRAB, and VREfm posing a public health threat. Meanwhile, the declining prevalence of MRSA indicates that infection control measures are effective against Gram-positive bacteria. Therefore, continuous surveillance of drug-resistant bacteria is essential, and antimicrobial stewardship measures must be implemented immediately to curb their spread. A limitation of this study is that it was conducted at a single center, which may restrict the generalizability of the findings to other regions.