Background

Children in the intensive care unit (ICU) who suffer from severe basic diseases and low immunity are usually in critical condition. It is crucial to assist clinicians in selecting the appropriate empirical antibiotic therapies for clinical infection control.

Methods

We retrospectively analyzed data from 281 children with bloodstream infection (BSI). Comparisons of basic data, pathogenic information, and drug resistance of the main bacteria were conducted.

Results

We detected 328 strains, including Gram-positive bacteria (223, 68%), mainly coagulase-negative Staphylococci (CoNS); Gram-negative bacteria (91, 27.7%); and fungi (14, 4.3%). The results of the binary logistic regression analysis showed that the main basic disease was an independent risk factor for death. Compared with Escherichia coli, Klebsiella pneumoniae exhibited a higher proportion of extended-spectrum β-lactamases (ESBLs), and its resistance to some β-lactamides and quinolones antibiotics were lower. Twenty-seven isolates of multidrug-resistant (MDR) bacteria were detected, of which carbapenem-resistant Acinetobacter baumannii (CRAB) accounted for the highest proportion (13, 48.2%).

Conclusions

CoNS was the principal pathogen causing BSI in children in the ICU of children, and Escherichia coli was the most common Gram-negative pathogen. The main basic disease was an independent risk factor for death. It is necessary to continuously monitor patients with positive blood cultures, pay special attention to detected MDR bacteria, and strengthen the management of antibiotics and prevention and control of nosocomial infections.

中文翻译：

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华东地区儿童医学中心重症监护病房连续六年血流感染流行病学及耐药性分析

背景

重症监护病房（ICU）内患有严重基础疾病、免疫力低下的儿童通常病情危重。协助临床医生选择合适的经验性抗生素疗法来控制临床感染至关重要。

方法

我们回顾性分析了 281 名血流感染 (BSI) 儿童的数据。对主要细菌的基本数据、病原学信息、耐药性等进行比较。

结果

我们检测到328株菌株，其中革兰氏阳性菌（223株，68%），主要是凝固酶阴性葡萄球菌（CoNS）；革兰氏阴性菌（91，27.7%）；和真菌（14，4.3%）。二元logistic回归分析结果显示，主要基础疾病是死亡的独立危险因素。与大肠杆菌相比，肺炎克雷伯菌的超广谱β-内酰胺酶（ESBL）比例较高，对部分β-内酰胺类和喹诺酮类抗生素的耐药性较低。检出多重耐药（MDR）菌27株，其中碳青霉烯类耐药鲍曼不动杆菌（CRAB）所占比例最高（13株，48.2%）。

结论

CoNS是儿童ICU中引起BSI的主要病原菌，大肠埃希菌是最常见的革兰氏阴性病原菌。主要基础疾病是死亡的独立危险因素。要持续监测血培养阳性患者，特别关注检出的耐多药菌，加强抗生素管理和院内感染防控。