Analysis of etiology and clinical features of hospital-acquired bloodstream infection in children / 中华传染病杂志

ABSTRACT

Objective To summarize the pathogenic spectrum and antimicrobial susceptibility of hospital-acquired bloodstream infections (HABSI) in children,and to provide evidence for clinical antiinfection treatment.Methods During January 2004 to December 2011,the clinical data and drug susceptibility results of 168 children who were diagnosed with HABSI based on positive results of pathogen tests were reviewed retrospectively in Yuying Children's Hospital affiliated to Wenzhou Medical College.Results A total of 171 strains were isolated from blood specimens of the 168 children.The majority of HABSI occurred in the intensive care unit (73.7 ％),followed by department of hematology (22.6％).Gram-positive bacteria,gram-negative bacteria and fungi accounted for 53.8％,34.5％ and 11.7％,respectively.The predominant pathogens were Stagphylococcus epidermidis (14.1％),followed by Klebsiella pneumonia (13.5 ％),Staphylococcus haemolyticus (7.6％),Staphylococcus aureus (6.4％),Enterococcus faecium (6.4％) and Escherichia coli (6.4 ％).Staphylococcus aureus and Staphylococcus epidermidis resistant to methicillin were detected in 9.1 ％ and 91.7 ％ of specimens,respectively.Staphylococcus and enterococcus which were resistant to vancomycin or linezolid were not detected.The isolation rates of Klebsiella pneumoniae and Escherichia coli with extended-spectrum beta-lactamases (ESBL) were 95.7％ and 72.7％,respectively.One hundred and sixty cases (95.2 ％) had underlying diseases including premature birth and low birth weight (60.7％).One hundred and twenty-six cases (75.0％) underwent invasive procedures.The peak incidence of HABSI occurred in children less than 3 months old (75.6％).Conclusions HABSI is most common in infants younger than 3 months old,with underlying diseases or undergone invasive procedures.The pathogens are mainly gram-positive bacteria.Very low birth weight infants can acquire unusual infection of Kodamaea ohmeri.Thus,it is essential to strengthen the prevention of hospital-acquired infection.