Objective To understand the distribution and antimicrobial resistance of bacteria isolated from bronchoalveolar lavage fluid (BALF) in Sichuan Province over a five-year period,and provide a reference for antimicrobial therapy.Methods Bacteria were identified and subjected to antimicrobial susceptibility testing (including disk diffusion and automated systems) according to the protocol of the China Antimicrobial Resistance Surveillance System (CARSS).The results were interpreted according to the breakpoints recommended in CLSI M100 (2022 Edition).Results A total of 26575 strains of bacteria were included in this study,of which 83.2％ were Gram-negative bacteria and 16.8％ were Gram-positive bacteria.The top bacteria species were Klebsiella pneumoniae (19.8％),Pseudomonas aeruginosa (18.5％),Acinetobacter baumannii (12.3％),Staphylococcus aureus (7.7％),and Stenotrophomonas maltophilia (6.7％).None of S.aureus strains were resistant to vancomycin,teicoplanin,or linezolid.The prevalence of methicillin-resistant S.aureus (MRSA) was 32.5％.The resistance rate of Streptococcus pneumoniae to penicillin was 1.5％,and the resistance rate to erythromycin and clindamycin was>90％.The prevalence of β-lactamase-producing strains was 63.3％ in Haemophilus influenzae,while>90％ of H.influenzae strains were susceptible to levofloxacin.Less than 5％ of E.coli strains were resistant to carbapenems,and less than 15％ of the strains were resistant to cefoperazone-sulbactam and piperacillin-tazobactam.The resistance rate of K.pneumoniae to carbapenems increased year by year,from 11.1％ in 2019 to 19.1％ in 2023.The resistance rate of A.baumannii to most antimicrobial agents was>50％.The resistance rate of P.aeruginosa to carbapenems was about 15％.Conclusions The main bacteria isolated from BALF specimens in Sichuan Province are Gram-negative bacteria.The antimicrobial resistance of the bacterial isolates is on the rise.For the patients suspected of lower respiratory tract infection,clinical practitioners should collect more high-quality BALF specimens for microbiology testing.Surveillance of the distribution and antimicrobial susceptibility of the pathogens in respiratory tract infections can inform better empirical treatment.
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