Objective To summarize the changing distribution and antimicrobial resistance profiles of Enterobacterales strains isolated from children in CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Methods Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were analyzed according to CLSI 2021 breakpoints.Results A total of 81 681 strains isolated from children were collected from 2015 to 2021,accounting for 50.1％of gram-negative isolates from children.The most frequently isolated species were Escherichia coli,Klebsiella spp.and Enterobacter spp..The main source of the isolates was urine and respiratory tract,accounting for 29.3％and 27.7％,respectively.The prevalence of extended-spectrum β-lactamase in E.coli,Klebsiella pneumoniae and Proteus mirabilis was 48.8％-57.6％,49.3％-66.7％,and 23.1％-33.8％,respectively.The prevalence of carbapenem-resistant Enterobacterales was 5.7％-9.5％,with a decreasing trend over the 7-year period.The prevalence of carbapenem-resistant Klebsiella spp.,carbapenem-resistant Enterobacter spp.,and carbapenem-resistant E.coli was 14.1％-22.6％,7.1％-15.7％,and 2.0％-3.4％,respectively.The Enterobacterales showed higher resistance rates to ciprofloxacin compared to levofloxacin.The Enterobacterales strains were still highly susceptible to amikacin,polymyxin B,and tigecycline.More than 70％of the Salmonella spp.strains were resistant to ampicillin,while lower than 30％of these strains were ressitant to ceftriaxone.Conclusions Some Enterobacterales species isolated from children such as E.coli and K.pneumoniae showed decreasing resistance to commonly used antimicrobial agents.However,continuous monitoring of bacterial resistance should be strengthened in order to prevent and control the spread of drug-resistant bacteria.
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