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April 1, 2026Infection and Drug Resistance0 citationsOpen Access

Prevalence Trends and Antimicrobial Resistance of Carbapenem-Resistant Gram-Negative Bacteria in Paediatric Patients in Sichuan Province: A Retrospective Study (2021-2025)

ZYZhuorui You XHXiangning Huang XLXin Liu

Key Points

This study investigates the prevalence and resistance profiles of carbapenem-resistant Gram-negative bacteria in pediatric patients.
Retrospective analysis of CRGNB isolates from hospitalized children aged ≤ 14 years.
Data collection from 134 medical institutions in Sichuan Province from 2021 to 2025.
Bacterial identification and susceptibility testing conducted using standard protocols.
Data analyzed using WHONET software.
A total of 2523 CRGNB isolates were identified, with 56.4% from male patients.
The highest number of isolates came from infants aged 29 days to ≤ 1 year (41.8%).
K. pneumoniae was the most common isolate (41.8%), followed by A. baumannii (22.1%) and E. coli (10.0%).
High susceptibility rates (> 96%) were observed for Enterobacterales to tigecycline and polymyxin B.

Abstract

Objective: Antimicrobial resistance (AMR) represents one of the most pressing global public health threats. This study aimed to analyze the distribution and antimicrobial resistance profiles of Carbapenem-resistant Gram-negative Bacteria (CRGNB) isolated from pediatric patients in Sichuan Province, China, in order to provide evidence to support rational antimicrobial use and infection prevention and control in clinical practice. Methods: This retrospective study included non-duplicate CRGNB isolates recovered from hospitalized children aged ≤ 14 years in 134 medical institutions across Sichuan Province from 2021 to 2025. Bacterial identification and antimicrobial susceptibility testing were performed according to a unified surveillance protocol. CRGNB was defined, in accordance with CLSI M100, 34th edition (2024), as isolates resistant to at least one carbapenem (imipenem, meropenem, or ertapenem). Data were analyzed using WHONET 5.6. Results: A total of 2523 CRGNB isolates were collected. Isolates from male patients accounted for 56.4% (1422/2523), and the largest proportion of isolates was from the 29 days to ≤ 1 year age group (41.8%, 1054/2523). The five most frequently isolated species were Klebsiella pneumoniae (41.8%, 1055/2523), Acinetobacter baumannii (22.1%, 558/2523), Escherichia coli (10.0%, 252/2523), Enterobacter cloacae complex (9.3%, 235/2523), and Pseudomonas aeruginosa (6.4%, 162/2523), with respiratory specimens accounting for most isolates (59.6%, 1504/2523). Enterobacterales showed susceptibility rates > 96% to tigecycline and polymyxin B. K. pneumoniae showed 87.5% susceptibility to ceftazidime-avibactam. A. baumannii exhibited low resistance only to polymyxin B and tigecycline (2.3% and 2.5%, respectively). P. aeruginosa showed 100% susceptibility to ceftazidime-avibactam and polymyxin B. Conclusion: CRGNB infections among children in Sichuan Province remain severe and display marked regional characteristics, with infants constituting a high-risk population. The increasing prevalence of multidrug-resistant organisms poses a substantial challenge to clinical management and warrants close surveillance and targeted intervention. Keywords: Sichuan Province, China, children, antimicrobial resistance, carbapenem resistance

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