Zhengting Liu, Liqin Zhang, Jian Zou
Objective This study aimed to analyze the distribution characteristics and dynamic trends of antimicrobial resistance among pathogens isolated from blood cultures of adult patients at a large tertiary hospital in southern Jiangxi Province, China, from 2020 to 2024, in order to provide evidence-based guidance for the prevention and treatment of bloodstream infections. Methods This study conducted a retrospective analysis of non-repetitive isolates from blood cultures of adult patients at a large tertiary hospital in southern Jiangxi Province between 2020 and 2024. Statistical analysis was performed using WHONET 5.6 and SPSS Statistics 30 software. Results This study included a total of 3,695 pathogenic bacteria, with Gram-negative bacteria predominating (61.92%,2,288/3,695). Among Gram-negative bacteria, Escherichia coli (28.99%,1,071/3,695) and Klebsiella pneumoniae (14.72%,544/3,695) were the most prevalent. Antimicrobial resistance analysis revealed that the detection rate of carbapenem-resistant Klebsiella pneumoniae (CRKP) surged sharply from 1.2% (1/82) in 2020 to 21.8% (26/119) in 2024; the detection rate of carbapenem-resistant Acinetobacter baumannii (CRAB) increased from 33.3%(5/15) in 2020 to 76.5% (13/17) in 2024. In contrast, the detection rate of methicillin-resistant Staphylococcus aureus (MRSA) decreased significantly from 24.3% (17/73) in 2020 to 13.5% (10/74) in 2024. Among Enterococci , the rate of high-level gentamicin resistance (HLGR, defined as resistance to 500 µg/ml gentamicin) in Enterococcus faecium increased significantly, from 10% (1/10) in 2020 to 66.7% (14/21) in 2024, and vancomycin-resistant Enterococcus faecium (VREfm) was detected at a rate of 9.5% (2/21) in 2024. Conclusion In a tertiary hospital in southern Jiangxi, China, Gram-negative bacteria predominate among Patients with positive blood cultures, with sharply rising detection rates of CRKP , CRAB , and VREfm posing a public health threat. Meanwhile, the declining prevalence of MRSA indicates that infection control measures are effective against Gram-positive bacteria. Therefore, continuous surveillance of drug-resistant bacteria is essential, and antimicrobial stewardship measures must be implemented immediately to curb their spread. A limitation of this study is that it was conducted at a single center, which may restrict the generalizability of the findings to other regions.