Clinical Research Of Bacteria Spectrum And The Change Of Bacterial Drug Resistance About Pediatric Diseases During Six Years

Objective: To investigate the distribution of bacteria spectrum and the change of bacterial drug resistance about pediatric diseases in our hospital within six years, so as to provide a reliable basis for clinicians to choose suitable antibiotics, thus reducing and slowing down bacterial drug resistance.Methods: A retrospective survey is carried out on cultivating positive bacteria in pediatric inpatients in our hospital within six years. A drug-sensitive analysis is conducted with WHONET5.4 software for two groups of data, with isolation strain from January 2005 to December 2007 as group A, while that from January 2008 to December 2010 as group B.Research: 1. In six years, 1674 strains have been isolated, and 515 Gram-positive bacteria G+, 1057 Gram-negative bacteria G-, 50 Candida albicans and the other 52 have been isolated. Besides, 582 bloodstream infection strains, 1046 digestive tract infection strains, and 46 other parts of the infection strains have been isolated. Major species are as follows: 819 E. coli, 70 Klebsiella, 43 Staphylococcus aureus, 309 coagulase negative staphylococcus, 140 Enterococcus, 62 Enterobacter, 23 Streptococcus, 40 Shigella, 20 Pseudomonas aeruginosa, 50 Candida, 46 Salmonella and 52 other strains. 2. In group A, 902 strains have been isolated, mainly including 465 Escherichia coli (51.6%), 138 CNS(15.3%), 78 Enterococcus (8.6%), 54 Klebsiella (6%), 39 Enterobacteriaceae (4.3%), 26 candidiasis (2.9%), 19 Shigella (2.1%), 12 streptococci (1.3%), 18 Salmonella (2%), 17 Staphylococcus aureus (1.9 %), 8 Pseudomonas aeruginosa (0.9%) and 28 others (3.4%). 3. In group B, 772 strains have been isolated, mainly including 354 Escherichia coli (45.9%), 171 CNS (22.2%), 62 Enterococcus (8%), 21 Shigella (2.7% ), 24 Candida (3.1%), 16 Klebsiella (2.1%), 28 Salmonella (3.6%), 26 Staphylococcus aureus (3.4%), 23 Enterobacteriaceae (3%), 11 Streptococcus ( 1.4%), 12 Pseudomonas aeruginosa (1.6%) and 24 others (3.1%). 4. The drug resistance rate of two groups of isolated strains to the following antibiotics are stated here: ampicillin (69.5%, 72.4%), cefazolin (68.7%, 79.3%), cotrimoxazole (66%, 66.8%), ceftazidime ( 64.4%, 66.6%), gentamicin (63.1%, 70.2%), levofloxacin (52.5%, 53.4%), Ceftriaxone (51.2%, 55.2%), tobramycin (43.9%, 45.1%) , oxacillin (39.2%, 45.5%), penicillin (33.5%, 47.5%), erythromycin (27.3%, 38.1%), tetracycline (25.8%, 34.8%), clindamycin (21.7%, 28.8 ), amikacin (17.6%, 18.1%), rifampicin (14.3%, 20.2%), nitrofurantoin (12.7%, 13%), sent La Xilin / tazobactam (10.6%, 11.9% ), imipenem (1%, 0.9%), Escherichia coli, extended-Spectrum beta-lactamases-positive strains(62.8%, 69.8%), Klebsiella spp extended-spectrum beta-lactamases-positive isolates (27.8%, 56.3%). Research findings show that there are no vancomycin resistant strains, but an increasing number of multi-resistant strains and Pan-resistant strains, while Candida resistance is low and itraconazole resistance is the highest amounting to 46.2%. Conclusion: Among pediatric infectious diseases, gram-negative bacterial infections take up the most, and in recent years gram-positive bacterial infections have increased year by year. Besides, drug resistance rate of bacteria is much higher and tends to rise recently. Meanwhile, extended-spectrum beta-lactamases-producing strains, multi-drug resistant strains and Pan-resistant strains are increasing gradually. Drug-resistant strains have not been currently found in vancomycin, so clinicians should avoid the application of vancomycin as first-line drugs to minimize and prevent emergence of resistant strains.