Trend of distribution and antimicrobial resistance in uropathogens in China from the CHINET antimicrobial resistance surveillance program, a 7-year retrospective study
Authors: Li Yanming , Zou Mingxiang , Yan Qun , Liao Jingzhong , Liu Wenen ,   on behalf of the China Antimicrobial Surveillance Network (CHINET) Study Group, Yang Yang , Hu Fupin , Zhu Demei , Xu Yingchun , Zhang Xiaojiang , Zhang Fengbo , Ji Ping , Xie Yi , Kang Mei , Wang Chuanqing , Fu Pan , Xu Yuanhong , Huang Ying , Chen Zhongju , Sun Ziyong , Ni Yuxing , Sun Jingyong , Chu Yunzhuo , Tian Sufei , Hu Zhidong , Li Jin , Yu Yunsong , Lin Jie , Shan Bin , Du Yan , Guo Sufang , Wang Yanyan , Wei Lianhua , Zou Fengmei , Zhang Hong , Wang Chun , Hu Yunjian , Ai Xiaoman , Zhuo Chao , Su Danhong , Guo Dawen , Zhao Jinying , Huang Xiangning , Yu Hua , Jin Yan , Shao Chunhong , Xu Xuesong , Yan Chao , Wang Shanmei , Chu Yafei , Zhang Lixia , Ma Juan , Zhou Shuping , Zhou Yan , Zhu Lei , Meng Jinhua , Dong Fang , Lu Zhiyong , Hu Fangfang , Shen Han , Zhou Wanqing , Li Gang , Jia Wei , Wu Jinsong , Lu Yuemei , Li Jihong , Duan Jinju , Kang Jianbang , Ma Xiaobo , Zheng Yanping , Guo Ruyi , Zhu Yan , Chen Yunsheng , Meng Qing , Wang Shifu , Hu Xuefei , Shen Jilu , Wang Ruizhong , Fang Hua , Yu Bixia , Gong Ping , Zhao Yong , Weng Kaizhen , Zhang Yirong , Liu Jiangshan , Liao Longfeng , Gu Hongqin , Jiang Lin , He Wen , Xue Shunhong , Feng Jiao , Yue Chunlei 
Published: May 2024

Urinary tract infections (UTIs) are common urological diseases that easily relapse and have led to an increasing economic and health burdens. The China Antimicrobial Surveillance Network (CHINET) system is one of the most influential antimicrobial resistance surveillance networks in China. This study analyzed antimicrobial resistance and distribution trends of uropathogens from 2015 to 2021 using the CHINET system. A total of 261,893 non-duplicate strains were collected; Gram-positive bacteria accounted for 23.8% while Gram-negative bacteria accounted for 76.2%. Escherichia coli, Enterococcus faecium, Klebsiella pneumoniae, and Enterococcus faecalis were the most common species. The resistance to vancomycin, linezolid, and teicoplanin in E. faecalis and E. faecium was less than 3%. The prevalence of carbapenem-resistant strains of E. coli, K. pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii was 1.7%, 18.5%, 16.4%, and 40.3%, respectively. The prevalence of carbapenem-resistant A. baumannii increased from 27.6% in 2015 to 43.4% in 2021. The prevalence of methicillin-resistant Staphylococcus aureus decreased from 40.6% in 2015 to 22.9% in 2021. The resistance rates to most β-lactam antimicrobials, aminoglycosides and fluoroquinolones in E. coli, K. pneumoniae, P. aeruginosa and A. baumannii isolated from ICU inpatients were significantly higher than in those isolated from outpatients and non-ICU inpatients. This study indicates that E. coli, Enterococcus, and K. pneumoniae were the most commonly isolated uropathogens in China. The bacterial species isolated and their antimicrobial resistance patterns differed in different patient populations. More attention must be paid uropathogen resistance surveillance to provide data for the rational use of antimicrobial agents.