Carbapenem-Resistant Gram-Negative Bacilli in China: Current Situation and Trend Inference (2014-2029)

The objective of this study was to analyze longitudinal trends in the detection rates of Carbapenem-resistant Gram-negative bacilli (CRGNB) in China from 2014 to 2024, and to forecast their evolution over the subsequent five years. Surveillance data were extracted from the annual reports of the China Antimicrobial Resistance Surveillance System (CARSS). In the period between 2014 and 2024, carbapenem-resistant Acinetobacter baumannii (CRAB) was identified with the highest frequency (range: 52.20%-60.00%), followed by carbapenem-resistant Pseudomonas aeruginosa (CRPA) (16.00%-25.60%), carbapenem-resistant Klebsiella pneumoniae (CRKP) (6.40%-11.30%), and carbapenem-resistant Escherichia coli (CREC) (1.50%-1.90%). Joinpoint analysis revealed a significant overall decreasing trend for CRPA (Average Annual Percentage Change, AAPC = -4.64%) and CRAB (AAPC = -1.05%). CRKP demonstrated a significant overall increase (AAPC = 4.29%), characterized by a sharp rise from 2014 to 2019 (Annual Percentage Change, APC = 10.73%, p < 0.01) followed by a plateau and nonsignificant decline (APC = -1.77%, p = 0.31). CREC exhibited a non-significant decreasing trend (AAPC = -1.42%, p = 0.16). The Autoregressive Integrated Moving Average (ARIMA) models, which were fitted to the data, demonstrated excellent predictive accuracy. Projections for 2025 indicate detection rates of 1.61% for CREC, 9.63% for CRKP, 14.25% for CRPA, and 52.39% for CRAB. Projections indicate a persistent downward trajectory over the ensuing five-year period, thereby substantiating the ongoing necessity for antimicrobial stewardship and surveillance initiatives.