Epidemiological characteristics and antimicrobial resistance profiles of clinical bacterial isolates in a tertiary hospital in Zigong, southwestern China, 2023-2025.
- 1Department of Clinical Laboratory, Zigong First People's Hospital, Zigong, China.
Abstract
Antimicrobial resistance (AMR) varies across hospitals, patient populations, and care settings, limiting the clinical utility of aggregate surveillance data. We characterized bacterial distribution and antimicrobial resistance at a tertiary hospital in Zigong, southwestern China, during 2023-2025, with explicit stratification by age and care setting. This retrospective laboratory surveillance study retained the first isolate of each bacterial species per patient per calendar year. We reinterpreted available minimum inhibitory concentrations (MICs) and inhibition-zone diameters using Clinical and Laboratory Standards Institute (CLSI) M100 (35th edition, 2025). Resistance proportions used antimicrobial-specific tested denominators. We estimated temporal associations with logistic regression, modeling calendar year ordinally, using patient-clustered robust standard errors, and adjusting for age, sex, and care setting; we controlled exploratory comparisons using the Benjamini-Hochberg false discovery rate. From 18,581 laboratory records, 1,615 repeat records were excluded, leaving 16,966 isolates. Isolates were predominantly from general wards (15,478/16,966, 91.2%); 1,330 (7.8%) were ICU/critical-care isolates, and 158 (0.9%) were outpatient isolates. Carbapenem resistance occurred in 70/4,848 Escherichia coli (1.4%) and 63/1,769 Klebsiella pneumoniae (3.6%). Carbapenem-resistant Pseudomonas aeruginosa (CRPA) occurred in 190/1,659 isolates (11.5%), and carbapenem-resistant Acinetobacter baumannii (CRAB) in 128/380 isolates (33.7%); ICU/critical-care status was associated with both phenotypes (adjusted OR 2.80 and 4.29, respectively). Phenotypic linezolid non-susceptibility was observed in 60/325 Enterococcus faecalis isolates (18.5%; annual range 17.3%-19.0%) without a temporal trend. Among adult Haemophilus influenzae, ampicillin resistance increased from 35/50 (70.0%) to 214/243 (88.1%; adjusted OR/year 1.73, 95% CI 1.19-2.50), and amoxicillin/clavulanate resistance increased from 8/50 (16.0%) to 145/243 (59.7%; adjusted OR/year 3.06, 95% CI 2.18-4.30). AMR differed by care setting and age. Carbapenem resistance in E. coli and K. pneumoniae remained uncommon, whereas CRAB and CRPA were concentrated in ICU/critical-care isolates. The substantial proportion of phenotypic linezolid non-susceptibility in E. faecalis warrants confirmation by reference susceptibility testing, and increasing β-lactam resistance among adult H. influenzae warrants continued surveillance. These findings support regularly updated institution- and care-setting-specific cumulative antibiograms, with age stratification where isolate numbers are adequate; causal inferences regarding stewardship effects or patient outcomes require linked clinical datasets.
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BibTeX
@article{yu2026epidemiological,
title = {{Epidemiological characteristics and antimicrobial resistance profiles of clinical bacterial isolates in a tertiary hospital in Zigong, southwestern China, 2023-2025.}},
author = {Jianhong Yu and Yu Chen and Xianyu You and Suchuan Zhang},
journal = {Frontiers in cellular and infection microbiology},
year = {2026},
month = oct,
doi = {10.3389/fcimb.2026.1947772},
url = {https://europepmc.org/article/MED/42952654},
note = {CC BY},
}
RIS
TY - JOUR
TI - Epidemiological characteristics and antimicrobial resistance profiles of clinical bacterial isolates in a tertiary hospital in Zigong, southwestern China, 2023-2025.
AU - Jianhong Yu
AU - Yu Chen
AU - Xianyu You
AU - Suchuan Zhang
PY - 2026
DA - 2026/10/14
JO - Frontiers in cellular and infection microbiology
DO - 10.3389/fcimb.2026.1947772
UR - https://europepmc.org/article/MED/42952654
AB - Antimicrobial resistance (AMR) varies across hospitals, patient populations, and care settings, limiting the clinical utility of aggregate surveillance data. We characterized bacterial distribution and antimicrobial resistance at a tertiary hospital in Zigong, southwestern China, during 2023-2025, with explicit stratification by age and care setting. This retrospective laboratory surveillance study retained the first isolate of each bacterial species per patient per calendar year. We reinterpreted available minimum inhibitory concentrations (MICs) and inhibition-zone diameters using Clinical and Laboratory Standards Institute (CLSI) M100 (35th edition, 2025). Resistance proportions used antimicrobial-specific tested denominators. We estimated temporal associations with logistic regression, modeling calendar year ordinally, using patient-clustered robust standard errors, and adjusting for age, sex, and care setting; we controlled exploratory comparisons using the Benjamini-Hochberg false discovery rate. From 18,581 laboratory records, 1,615 repeat records were excluded, leaving 16,966 isolates. Isolates were predominantly from general wards (15,478/16,966, 91.2%); 1,330 (7.8%) were ICU/critical-care isolates, and 158 (0.9%) were outpatient isolates. Carbapenem resistance occurred in 70/4,848 Escherichia coli (1.4%) and 63/1,769 Klebsiella pneumoniae (3.6%). Carbapenem-resistant Pseudomonas aeruginosa (CRPA) occurred in 190/1,659 isolates (11.5%), and carbapenem-resistant Acinetobacter baumannii (CRAB) in 128/380 isolates (33.7%); ICU/critical-care status was associated with both phenotypes (adjusted OR 2.80 and 4.29, respectively). Phenotypic linezolid non-susceptibility was observed in 60/325 Enterococcus faecalis isolates (18.5%; annual range 17.3%-19.0%) without a temporal trend. Among adult Haemophilus influenzae, ampicillin resistance increased from 35/50 (70.0%) to 214/243 (88.1%; adjusted OR/year 1.73, 95% CI 1.19-2.50), and amoxicillin/clavulanate resistance increased from 8/50 (16.0%) to 145/243 (59.7%; adjusted OR/year 3.06, 95% CI 2.18-4.30). AMR differed by care setting and age. Carbapenem resistance in E. coli and K. pneumoniae remained uncommon, whereas CRAB and CRPA were concentrated in ICU/critical-care isolates. The substantial proportion of phenotypic linezolid non-susceptibility in E. faecalis warrants confirmation by reference susceptibility testing, and increasing β-lactam resistance among adult H. influenzae warrants continued surveillance. These findings support regularly updated institution- and care-setting-specific cumulative antibiograms, with age stratification where isolate numbers are adequate; causal inferences regarding stewardship effects or patient outcomes require linked clinical datasets.
SN - 2235-2988
ER -