The Analysis of Drug-Resistant Bacteria from Different Regions of Anhui in 2021

Figures & data

Table 1 The Composition of Pathogenic Bacteria in Different Areas of Anhui Province in 2021

Bacteria	Northern Anhui		Center Anhui		Southern Anhui		χ^2	P
	Isolates	%	Isolates	%	Isolates	%
Gram-positive bacteria	10,307		14,875		9554
Staphylococcus aureus	3424	33.2	4962	33.4	3101	32.5	2.281	0.32
Staphylococcus epidermidis	1605^a	15.6	1906	12.8	1276^c	13.4	40.998	<0.0001
Staphylococcus hominis	912^a	8.8	1105^b	7.4	606^c	6.3	45.144	<0.0001
Enterococcus faecium	910^a	8.8	1444^b	9.7	1011^c	10.6	17.427	<0.0001
Enterococcus faecalis	798^a	7.7	1683	11.3	1038^c	10.9	93.118	<0.0001
Gram-negative bacteria	29,008		39,908		29,616
Escherichia coli	8848	30.5	12,126	30.4	9096	30.7	0.869	0.648
Klebsiella pneumoniae	6158^a	21.2	7998^b	20	6620^c	22.4	55.103	<0.0001
Pseudomonas aeruginosa	4115	14.2	5685^b	14.2	3992^c	13.5	9.498	0.009
Acinetobacter baumannii	2460^a	8.5	3831^b	9.6	2611	8.8	28.06	<0.0001
Enterobacter cloacae	937^a	3.2	1622	4.1	1293^c	4.4	54.607	<0.0001

Notes: ^aThe statistical difference between northern Anhui and central Anhui; ^bThe statistical difference between central Anhui and southern Anhui; ^cThe statistical difference between southern Anhui and northern Anhui.

Table 2 Constituent of Major Specimen Sourses of Bacteria in Different Areas of Anhui Province in 2021

Bacteria	Northern Anhui		Center Anhui		Southern Anhui		χ^2	P
	Isolates	%	Isolates	%	Isolates	%
Sputum	16,079^a	40.9	20,329^b	37.1	14,930^c	38.1	142.671	<0.0001
Urine	6262^a	15.9	11,783^b	21.5	10,365^c	26.5	1300.016	<0.0001
Blood	4915^a	12.5	6462^b	11.8	3761^c	9.6	181.478	<0.0001
Pus	4153^a	10.6	3928^b	7.2	2521^c	6.4	534.805	<0.0001
Ascites	771^a	2.0	830^b	1.5	944^c	2.4	98.440	<0.0001
Bile	699^a	1.8	1093^b	2.0	581^c	1.5	34.219	<0.0001
Cerebrospinal fluid	307^a	0.8	197^b	0.4	88^c	0.2	152.320	<0.0001
Pleural effusion	252^a	0.6	254	0.5	188^c	0.5	15.676	<0.0001
Bronchoalveolar fluid	224^a	0.6	447^b	0.8	75^c	0.2	160.108	<0.0001
Faeces	126^a	0.3	228^b	0.4	61^c	0.2	50.083	<0.0001

Notes: ^aThe statistical difference between northern Anhui and central Anhui; ^bThe statistical difference between central Anhui and southern Anhui; ^cThe statistical difference between southern Anhui and northern Anhui.

Table 3 Resistance Rate of Staphylococcus aureus and Coagulase-Negative Staphylococcus in Different Regions of Anhui Province

Antibacterial Agents	Staphylococcus aureus						χ^2	P	Coagulase-negative Staphylococcus						χ^2	P
	Northern Anhui		Center Anhui		Southern Anhui				Northern Anhui		Center Anhui		Southern Anhui
	Isolates	%	Isolates	%	Isolates	%			Isolates	%	Isolates	%	Isolates	%
PEN	3287^a	96	4369	93	2656^c	92.2	43.84	<0.0001	3427^a	92.8	4427^b	91.5	2729^c	89.8	17.318	<0.0001
GEN	3394	7.1	4953^b	7.7	3082^c	4.9	2588.077	<0.0001	3684^a	14.6	4837^b	16.8	3333^c	18.5	19.554	<0.0001
RIF	3411^a	1.2	4953^b	2	3083^c	1.4	743.321	<0.0001	3675	7.2	4826	6.8	3328	7.4	1.172	0.556
LVX	3282^a	12.6	4622	14.6	2940	13.6	6.469	0.039	3468	46	4570^b	44.3	3147	46.9	5.421	0.067
SMX	3406^a	14.4	3889	7.2	2842^c	6	162.441	<0.0001	3680^a	45	3785^b	35.6	3009^c	29.8	170.308	<0.0001
CLI	3261^a	34.1	4814^b	24.7	3070^c	20.3	166.109	<0.0001	3431^a	34.6	4724^b	28.1	3305^c	30.3	39.882	<0.0001
ERY	3154^a	64.2	4665^b	52	3098^c	45.2	235.471	<0.0001	3453^a	80.7	4447^b	76.6	3342^c	73.9	45.395	<0.0001
LNZ	3287	0	4895	0	3077	0	NA		3433	0	4719	0.4	3277	0	NA
VAN	3389	0	4912	0	2804	0	NA		3652	0	4815	0	3077	0	NA
TEC	671	0	711	0	380	0	NA		352	0	354	0	469	0	NA

Notes: ^aThe statistical difference between northern Anhui and central Anhui; ^bThe statistical difference between central Anhui and southern Anhui; ^cThe statistical difference between southern Anhui and northern Anhui.

Abbreviations: PEN, penicillin; GEN, gentamicin; RIF, rifampicin; LVX, levofloxacin; SMX, sulfamethoxazole; CLI, clindamycin; ERY, erythromycin; LNZ, linezolid; VAN, vancomycin; TEC, teicoplanin.

Table 4 Resistance Rate of Enterococcus faecalis and Enterococcus faecium in Different Regions of Anhui Province

Antibacterial Agents	Enterococcus faecalis						χ^2	P	Enterococcus faecium						χ^2	P
	Northern Anhui		Center Anhui		Southern Anhui				Northern Anhui		Center Anhui		Southern Anhui
	Isolates	%	Isolates	%	Isolates	%			Isolates	%	Isolates	%	Isolates	%
AMP	776	3.7	1487	3	910	4.2	2.321	0.313	882^a	90.8	1302	86.9	859^c	85.9	11.348	0.003
GEH	615^a	41.8	1300^b	30.2	529^c	35.3	25.131	<0.0001	709^a	54.7	1138^b	42.4	603	49.8	27.636	<0.0001
STH	413^a	26.9	970^b	19.7	372	26.3	11.884	0.003	557^a	32.9	882^b	27.2	327^c	19.3	19.158	<0.0001
RIF	202	54.8	178	58.4	315	55.6	0.538	0.764	258	53.8	136^b	55.1	287^c	85.4	72.93	<0.0001
CIP	556^a	37.8	1363	32.7	564	34.6	4.496	0.106	714	86.3	1218^b	87.3	483	82.6	6.314	0.043
LVX	777^a	38.2	1563^b	29	962^c	33.7	21.019	<0.0001	873	85.6	1333^b	83.6	989^c	80.4	9.199	0.01
LNZ	583^a	0.9	1489^b	2.5	961	1.2	8.618	0.013	843	0.2	1380	0.4	980	0.4	0.646	0.724
VAN	794	0.4	1650	0.2	1007	0.2	0.857	0.651	890	0.9	1439	0.6	992	0.3	2.811	0.245
TEC	79	1.3	239	1.3	246	0.8	0.268	0.875	111	3.6	225	1.3	270	0.7	4.463	0.107

Notes: ^aThe statistical difference between northern Anhui and central Anhui; ^bThe statistical difference between central Anhui and southern Anhui; ^cThe statistical difference between southern Anhui and northern Anhui.

Abbreviations: AMP, ampicillin; GEH, gentamicin-high; STH, streptomycin-high; RIF, rifampicin; CIP, ciprofloxacin; LVX, levofloxacin; LNZ, linezolid; VAN, vancomycin; TEC, teicoplanin.

Table 5 Resistance Rate of Escherichia coli and Klebsiella pneumoniae in Different Regions of Anhui Province

Antibacterial Agents	Escherichia coli						χ^2	P	Klebsiella pneumoniae						χ^2	P
	Northern Anhui		Center Anhui		Southern Anhui				Northern Anhui		Center Anhui		Southern Anhui
	Isolates	%	Isolates	%	Isolates	%			Isolates	%	Isolates	%	Isolates	%
AMK	8001^a	5	11,616^b	2.6	9094^c	1.8	160.182	<0.0001	5424^a	13.7	7651^b	11.1	6617^c	5.6	235.193	<0.0001
GEN	3461^a	44	8203^b	32.9	6249^c	30.2	198.679	<0.0001	2242^a	29	4927^b	26.3	3158^c	19.6	47.919	<0.0001
AMC	2409^a	17.5	4118	10.9	3197^c	10.9	72.482	<0.0001	2691^a	28.6	3068^b	21.8	2544	26.4	36.944	<0.0001
SAM	2832^a	57.7	7565^b	45.1	5068^c	40.9	211.422	<0.0001	1807	43.6	4736^b	41	2659^c	31.6	85.492	<0.0001
TZP	8694^a	5.9	11,753^b	4.7	9061^c	3.2	74.321	<0.0001	5961	20.8	7804^b	20.7	6613^c	14.2	126.189	<0.0001
CSL	3491	6.4	5752^b	7.1	2614^c	4.4	22.198	<0.0001	2764	20.4	4345^b	21.4	1837	18.6	6.181	0.045
CXM	2108^a	62.7	5594^b	56.9	4763^c	44.3	258.757	<0.0001	2313^a	41.8	4211	38.3	3377	39.3	7.726	0.021
CRO	8239^a	60.8	10,914^b	55	8727^c	46.1	376.829	<0.0001	5663^a	36.9	7050^b	34.1	6450^c	29.9	67.987	<0.0001
CTX	353^a	51.8	1217^b	60.2	1182^c	45.6	51.674	<0.0001	282^a	40.1	615^b	52.8	869	42.7	19.406	<0.0001
CAZ	8748^a	29.5	12,105^b	25.3	8942^c	23	100.618	<0.0001	6094	29.2	7981^b	28.5	6578^c	22.1	103.946	<0.0001
FEP	8673^a	30	11,385	24.6	7247^c	24.5	90.259	<0.0001	6093	27.1	7540^b	27	5705^c	21.3	70.227	<0.0001
FOX	3541^a	14.1	4399^b	12.2	4954^c	8.1	82.623	<0.0001	3331^a	23.2	3420^b	19.9	3486^c	22.1	9.338	0.009
ATM	3462^a	43	8212^b	36.9	6146^c	33.7	82.465	<0.0001	2234	32.3	4952^b	33.5	3139^c	24.7	74.419	<0.0001
IPM	8774	2.3	11,918^b	2	9093^c	1.2	32.652	<0.0001	6109	15.6	7990^b	16.8	6617^c	9.1	197.123	<0.0001
MEM	886	1.2	2790^b	2.2	2831	1.1	11.511	0.003	607	14.3	1667	16.9	1687	14.5	4.415	0.11
CIP	3480^a	62.3	8198^b	52.5	4407^c	48.2	161.376	<0.0001	2247	32.7	5785^b	31.3	2481^c	17.4	192.112	<0.0001
CIP	8763^a	56.6	10,602^b	50.8	8602^c	45.7	206.918	<0.0001	6111^a	28	7970^b	24.8	6272^c	18.4	164.768	<0.0001
SMX	8793^a	61.3	10,041^b	49.2	8403^c	46.5	437.602	<0.0001	6085^a	29.2	5775	24.5	6166^c	25.7	36.657	<0.0001
TGC	3707	0.1	4871	0.1	4827	0.1	0.006	0.997	2467^a	1.3	3425^b	2.2	3225^c	4.4	56.811	<0.0001

Notes: ^aThe statistical difference between northern Anhui and central Anhui; ^bThe statistical difference between central Anhui and southern Anhui; ^cThe statistical difference between southern Anhui and northern Anhui.

Abbreviations: AMK, amikacin; GEN, gentamicin; AMC, amoxicillin/clavulanic acid; SAM, ampicillin/sulbactam; TZP, piperacillin/tazobactam; CSL, cefoperazone/sulbactam; CXM, cefuroxime; CRO, ceftriaxone; CTX, cefotaxime; CAZ, ceftazidime; FEP, cefepime; FOX, cefoxitin; ATM, aztreonam; IPM, imipenem; MEM, meropenem; CIP, ciprofloxacin; LVX, levofloxacin; SMX, sulfamethoxazole; TGC, tigecycline.

Table 6 Resistance Rate of Pseudomonas aeruginosa and Acinetobacter baumannii in Different Regions of Anhui Province

Antibacterial Agents	Pseudomonas aeruginosa						χ^2	P	Acinetobacter baumannii						χ^2	P
	Northern Anhui		Center Anhui		Southern Anhui				Northern Anhui		Center Anhui		Southern Anhui
	Isolates	R%	Isolates	R%	Isolates	R%			Isolates	R%	Isolates	R%	Isolates	R%
AMK	3630^a	5.8	5255	4.1	3974^c	3.4	28.1	<0.0001	343^a	46.1	2047	37	1928^c	36.7	11.442	0.003
GEN	1588^a	15.1	2753	9	2134^c	9.3	45.449	<0.0001	1048^a	69.9	1759^b	52.1	1072^c	58	86.556	<0.0001
TOB	2698^a	8.4	4807	7	3315^c	6	23.24	0.001	1696^a	67.3	3036^b	50.7	1989^c	43.5	217.177	<0.0001
TZP	3603^a	10.5	4756^b	14.6	3835^c	17.6	76.953	<0.0001	1894^a	73.2	2473	60	1185^c	58.1	104.601	<0.0001
CSL	1925^a	13.2	3264^b	17.5	1137	13.4	21.71	<0.0001	1222^a	56.2	2701^b	45.6	757^c	40.4	56.309	<0.0001
CAZ	3998	16.5	5568^b	17.1	3958^c	21.4	39.476	<0.0001	2444^a	70.3	3827^b	57.3	2606^c	52.3	181.713	<0.0001
FEP	4041	10.5	5587^b	11.7	3971^c	15.8	57.223	<0.0001	2446^a	63.2	3819^b	52.8	2561^c	48	122.779	<0.0001
IMP	3987^a	16.6	5367	21	3925^c	20.4	31.036	<0.0001	2452^a	69.8	3629^b	59.9	2198^c	46.4	263.425	<0.0001
MEM	2043^a	12	3921^b	19.6	2159^c	14.3	65.615	<0.0001	811^a	73.4	2400^b	64.2	1473^c	62.1	31.008	<0.0001
CIP	3479^a	17.7	5455	13.5	3116^c	14.8	29.719	<0.0001	1660^a	76.7	3354	57.3	1456^c	55.7	207.692	<0.0001
LVX	3942^a	17.6	5252^b	15.7	3190	18.1	9.894	0.007	2451^a	58.8	3706^b	47.8	2502^c	41	106.187	<0.0001
POL	70	1.4	709	1.8	325	0.3	4.997	0.082	51	2.0	664	1.1	250	0.8	0.168	0.791
MNO	–	–	–	–	–	–	–	–	1040^a	11.8	2227	15.4	1025	13.6	7.801	0.02
TGC	–	–	–	–	–	–	–	–	1080^a	2	2392	5.3	1076^c	6.4	25.558	<0.0001

Notes: ^aThe statistical difference between northern Anhui and central Anhui; ^bThe statistical difference between central Anhui and southern Anhui; ^cThe difference between southern Anhui and northern Anhui. “–”: No sensitivity test of the drug.

Abbreviations: AMK, amikacin; GEN, gentamicin; TOB, tobramycin; TZP, piperacillin/tazobactam; CSL, cefoperazone/sulbactam; CAZ, ceftazidime; FEP, cefepime; IPM, imipenem; MEM, meropenem; CIP, ciprofloxacin; LVX, levofloxacin; POL, Polymixin B; MNO, Minocycline; TGC, tigecycline.

Figure 1 The detection rates of methicillin-resistant staphylococci in different regions of Anhui. (A) Differences of detection rates of MRSA in northern, central and southern Anhui. (B) Differences of detection rates of MRCNS in northern, central and southern Anhui. (C) Prevalence of MRSA among different cities in Anhui (HuiNet data). (D) Prevalence of MRCNS among different cities in Anhui (HuiNet data). ***P<0.0001.

Abbreviations: MRSA, methicillin-resistant Staphylococcus aureus; MRCNS, methicillin-resistant coagulase-negative Staphylococcus; HuiNet, the Anhui Province Bacterial Resistance Surveillance Network.

Figure 2 The detection rates of vancomycin-resistant enterococcus in different regions of Anhui. (A) Differences of detection rates of VREA in northern, central and southern Anhui. (B) Differences of detection rates of VREM in northern, central and southern Anhui. (C) Prevalence of VREA among different cities in Anhui (HuiNet data). (D) Prevalence of VREM among different cities in Anhui (HuiNet data).

Abbreviations: VREA, vancomycin-resistant Enterococcus faecalis; VREM, vancomycin-resistant Enterococcus faecium; HuiNet, the Anhui Province Bacterial Resistance Surveillance Network.

Figure 3 The detection rates of third-generation cephalosporin-resistant Escherichia coli and Klebsiella pneumoniae in different regions of Anhui. (A) Differences of detection rates of CTX/CRO-R ECO in northern, central and southern Anhui. (B) Differences of detection rates of CTX/CRO-R KPN in northern, central and southern Anhui. (C) Prevalence of CTX/CRO-R ECO among different cities in Anhui (HuiNet data). (D) Prevalence of CTX/CRO-R KPN among different cities in Anhui (HuiNet data). ***P<0.0001.

Abbreviations: CTX/CRO-R ECO, third-generation cephalosporin-resistant Escherichia coli; CTX/CRO-R KPN, third-generation cephalosporin-resistant Klebsiella pneumoniae; HuiNet, the Anhui Province Bacterial Resistance Surveillance Network.

Figure 4 The detection rates of carbapenem-resistant Escherichia coli and Klebsiella pneumoniae in different regions of Anhui. (A) Differences of detection rates of CR-ECO in northern, central and southern Anhui. (B) Differences of detection rates of CR-KPN in northern, central and southern Anhui. (C) Prevalence of CR-ECO among different cities in Anhui (HuiNet data). (D) Prevalence of CR-KPN among different cities in Anhui (HuiNet data). ***P<0.0001.

Abbreviations: CR-ECO, carbapenem-resistant Escherichia coli; CR-KPN, carbapenem-resistant Klebsiella pneumoniae; HuiNet, the Anhui Province Bacterial Resistance Surveillance Network.

Figure 5 The detection rates of carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter baumannii in different regions of Anhui. (A) Differences of detection rates of CR-PAE in northern, central and southern Anhui. (B) Differences of detection rates of CR-ABA in northern, central and southern Anhui. (C) Prevalence of CR-PAE among different cities in Anhui (HuiNet data). (D) Prevalence of CR-ABA among different cities in Anhui (HuiNet data). ***P<0.0001.

Abbreviations: CR-PAE, carbapenem-resistant Pseudomonas aeruginosa; CR-ABA, carbapenem-resistant Acinetobacter baumannii; HuiNet, the Anhui Province Bacterial Resistance Surveillance Network.