Bacteriological monitoring and bacterial resistance analysis during five years in single center pediatric intensive care unit / 中国小儿急救医学

ABSTRACT

Objective:The characteristics of bacteriology and the change of drug resistance in PICU of our hospital during recent 5 years were analyzed to guide clinical rational drug use.Methods:All positive results of bacterial culture in PICU from January 2016 to December 2020 were retrospectively analyzed, and were classified according to the sample source, strain type and drug sensitivity results.The bacterial etiology spectrum and drug resistance in PICU were summarized.Results:A total of 800 pathogenic bacteria were isolated from the specimens collected from the PICU from January 2016 to December 2020, including 476 Gram-negative bacteria, 292 Gram-positive bacteria, and 32 fungi, accounting for 59.50%, 36.50%, and 4.00%, respectively.The top 9 bacteria were Staphylococcus aureus 134(16.75%), Haemophilusinfluenzae 79(9.88%), Klebsiellapneumoniae 78(9.75%), Streptococcus pneumoniae 74(9.25%), Escherichia coli 56(7.00%), Acinetobacterbaumannii 51(6.38%), Moraxella catarrhalis 48(6.00%), Enterobacter cloacae 26(3.25%), Pseudomonas aeruginosa 25(3.13%). Drug sensitivity results showed that 27(48.21%, 27/56)strains of EScherichia coli and 42(53.85%, 42/78) strains of Klebsiella pneumoniae were positive for ultrawide spectrum β-lactamase, and a total of 24(17.91%, 24/134)strains of methicillin-resistant Staphylococcus aureus were detected.Staphylococcus aureus was almost 100% resistant to penicillin G and ampicillin, and had high resistance rates to clindamycin and erythromycin(72.70% and 72.30%, respectively). It was 100% sensitive to minocycline, teicoranin, vancomycin, linezolid, and dattomycin.The drug resistance rates of Streptococcus pneumoniae to erythromycin and clindamycin were 98.60% and 98.50%, respectively.The drug resistance rates to azithromycin were 96.80%, the drug resistance rates to penicillin G, cefotaxime and ceftriaxone were 12.30%, 5.40% and 1.50%, respectively, and the drug resistance rates to moxifloxacin, linezolid and vancomycin were 100% sensitive.Conclusion:During the past five years, the etiology of the PICU in our hospital is mainly Gram-negative bacteria, and the most common pathogenic bacteria is Staphylococcus aureus.Klebsiella pneumoniae and Escherichia coli infections remain a great challenge.Bacterial resistance moitoring should be strengthened to provide evidence for the rational use of antibiotics.