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Background  Data on the pathogens responsible for nosocomial bloodstream infection (BSI) and their antimicrobial resistance (AMR) in Hubei province are limited. This study was conducted to determine the major pathogens causing BSI and to characterize their AMR.    Methods  Data from the China Antimicrobial Resistance Surveillance System (CARSS) from 2014 to 2016 were analyzed retrospectively.    Results   Escherichia coli, Staphylococcus aureus  and  Klebsiella pneumoniae  were the most common pathogens responsible for nosocomial BSI. Individuals aged 0–5 years and ≥ 40 years old were the major demographics at risk of infection by  E. coli, K. pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii  and  Enterobacter cloacae , while individuals aged 0–5 years were the major demographic at risk of infection by  S. aureus, Enterococcus faecalis, E. faecium, Streptococcus pneumoniae  and  Stenotrophomonas maltophilia . The frequencies of  E. coli  and  K. pneumoniae  isolates resistant to cefotaxime were 59.1% and 24.3%, respectively, and the frequencies of resistant isolates to ceftazidime were 42.9% and 27.2%, respectively. From 2014 to 2016, the frequency of extended-spectrum β-lactamase (ESBL)-positive  E. coli  declined from 29.07 to 24.5%, and the frequency of ESBL-positive  K. pneumoniae  declined from 18.64 to 12.33%. The frequency of carbapenem-resistant (CR)  E. coli  was below 0.5%, but 1–10% of  K. pneumoniae  isolates were CR.    Conclusions  The emergence of methicillin-resistant  S. aureus  and the expansion of ESBL and fluoroquinolone resistance among Gram-negative  Enterobacteriaceae  increased AMR severity. Carbapenemase-producing  K. pneumoniae  isolates responsible for nosocomial BSI increased year over year and effective infection control measures should be taken to prevent them from spreading.

bmc public health

Antimicrobial resistance of pathogens causing nosocomial bloodstream infection in Hubei Province, China, from 2014 to 2016: a multicenter retrospective study