Istribution And Drug Resistance Of Multidrug-resistant Bacteria In Pediatric Inpatients In Qingdao

Objective: To investigate the distribution and trend of multidrug-resistant bacteria in children hospitalized in a hospital in Qingdao,and to analyze the drug resistance of multiple drug-resistant bacteria.Methods: The multidrug-resistant bacteria isolated from pediatric hospitalized children from Qingdao University Hospital were analyzed retrospectively from 2013 to 2015,and their distribution and drug resistance were analyzed statistically.Results: A total of 469 pathogens were isolated from a top three hospitals in Qingdao,including 357 strains of multiple resistant strains,208 strains of Gram-positive bacteria,145 strains of Gram-negative bacteria and 4 strains of fungi.The most common multidrug-resistant strains were multiple resistant coagulase-negative staphylococci(MRCNS),followed by ESBLs-producing Escherichia coli,methicillin-resistant Staphylococcus aureus(MRSA);From 2013 to 2015,methicillin-resistant Staphylococcus aureus(MRSA)increased from 3.09% to 24.73%,ESBLs-producing Escherichia coli increased from 6.18%to 21.50%,HLAR increased from 1.03% to 6.45%,and the detection rate of ESBLs producing Lepidoma pneumoniae,Enterobacter cloacae and Acinetobacter baumannii was decreased year by year.The multidrug-resistant bacteria detected in the general pediatric department accounted for 40.89% of the total resistant bacteria,24.64% in the blood pediatrics and 34.47% in the neonatal department.The highest detection rate was blood(56.58%),followed by urine(14.29%),sputum(8.96%),Among them,multiple drug-resistant coagulase-negative staphylococci(MRCNS)and methicillin-resistant Staphylococcus aureus(MRSA)were the highest in the blood,acinetobacter baumannii,ESBLs-producing Klebsiella pneumoniae was the highest in sputum.Gram-positive bacteria on erythromycin,penicillin,clindamycin resistance rate is high,but for teicoplanin,tigecycline,nitrofurantoin more sensitive;Gram-negative bacteria on ampicillin,cefazolin,Cotrimoxazole resistance rate is high,but for eptafine,Biapenem,cephalosporins more sensitive.Conclusions:From 1990 to 2015,the multidrug-resistant bacteria in the hospitalized children were mainly Gram-positive bacteria and methicillin-resistant Staphylococcus aureus(MRSA),producing ESBLs pneumoniae,Enterobacter cloacae,Acinetobacter baumannii showed a declining trend year by year;The detection of multiple drug-resistant bacteria mainly on penicillins,third-generation cephalosporins,macrolide antibiotics have high resistance rate,has not yet cultivated for linezolid,vancomycin-resistant or mediated multiple drug-resistant bacteria,while the carbapenems,enzyme inhibitors compound preparation,glycopeptide antimicrobial susceptibility is higher,but the resistance rate increased,clinicians need to identify the site of infection in a timely manner to test the bacterial culture specimens,select the correct and effective antibiotic treatment,to avoid the emergence and spread of multiple drug-resistant bacteria.