AUTHOR=Zhou Yan , Zhou Shuping , Peng Jun , Min Liang , Chen Qiang , Ke Jiangwei 

TITLE=Bacterial distribution and drug resistance in blood samples of children in Jiangxi Region, 2017–2021

JOURNAL=Frontiers in Cellular and Infection Microbiology

VOLUME=13

YEAR=2023

URL=https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2023.1163312

DOI=10.3389/fcimb.2023.1163312

ISSN=2235-2988

ABSTRACT=<sec><title>Objective</title><p>This study aims to investigate the distribution and drug resistance of bacteria in clinical blood culture specimens from children in Jiangxi province in recent years and to provide a foundation for preventing and treating bloodstream infection diseases in children.</p></sec><sec><title>Methods</title><p>The study involved a statistical analysis of the isolation and drug resistance of bacterial strains obtained from blood culture specimens of children in Jiangxi province between 2017 and 2021. The analysis was performed using the WHONET 5.6 software.</p></sec><sec><title>Results</title><p>A total of 7,977 bacterial strains were isolated from the blood samples of children between 2017 and 2021. Of these, 2,334 strains (29.3%) were identified as Gram-negative bacteria, and 5,643 strains (70.7%) were identified as Gram-positive bacteria. The most commonly isolated pathogens were coagulase-negative <italic>Staphylococcus</italic>, <italic>Escherichia coli</italic>, and <italic>Staphylococcus aureus.</italic> Among the Gram-negative bacteria, <italic>Escherichia coli</italic> (840 strains, 36.0%), <italic>Klebsiella</italic> pneumoniae (385 strains), <italic>Salmonella</italic> (283 strains), <italic>Acinetobacter baumannii</italic> (137 strains), and <italic>Pseudomonas aeruginosa</italic> (109 strains) were the most prevalent. Among the Gram-positive bacteria, coagulase-negative <italic>Staphylococcus</italic> (3,424 strains, 60.7%), <italic>Staphylococcus aureus</italic> (679 strains), <italic>Streptococcus pneumoniae</italic> (432 strains), <italic>Enterococcus</italic> sp. (292 strains), and <italic>Streptococcus agalactiae</italic> (192 strains) were the most common. Resistance to third-generation cephalosporins (cefotaxime/ceftriaxone) was observed in 45.9% and 56.0% of <italic>Escherichia coli</italic> and <italic>Klebsiella pneumoniae</italic> strains, respectively, while resistance to carbapenems was observed in 4.6% and 20.3% of these strains, respectively. Resistance to third-generation cephalosporins (cefotaxime/ceftriaxone) was observed in 15.5% of <italic>Salmonella</italic> strains, while resistance to imipenem was absent. Carbapenem resistance was observed in 17.1% (20/117) and 13% (14/108) of <italic>Acinetobacter baumannii</italic> and <italic>Pseudomonas aeruginosa</italic> strains, respectively. Methicillin-resistant <italic>Staphylococcus aureus</italic> (MRSA) was detected in 32.7% of the strains, while methicillin-resistant coagulase-negative <italic>Staphylococcus</italic> was detected in 64.3% of the coagulase-negative <italic>Staphylococcus</italic> strains. No <italic>Staphylococcus</italic> bacteria resistant to vancomycin were detected. Four strains of vancomycin-resistant <italic>Enterococcus faecium</italic> were detected over the 5-year period, and one strain of linezolid-resistant <italic>Enterococcus faecalis</italic> was detected.</p></sec><sec><title>Conclusion</title><p>Gram-positive cocci were the most commonly isolated clinical pathogens in blood specimens from children in Jiangxi province. The composition of the pathogen species showed a slight change over the years. The detection ratios of pathogens varied with age group and season. Although the isolation rate of common carbapenem-resistant Enterobacter bacteria has decreased, it remains high. It is necessary to monitor the antimicrobial resistance of pathogens causing bloodstream infections in children more closely, and antimicrobial agents should be used with caution.</p></sec>