Joint surveillance and correlation analysis of antimicrobial resistance and consumption of seven targeted bacteria, 2017–2023

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.