Observational Study On Pathogenic Bacteria Of Hospital-Acquired Pneumonia In Hospitalized Children

Objective: To summarize the basic characteristics,bacterial distribution and drug resistance of hospital-acquired pneumonia(HAP)in children,so as to provide guidance for the clinical use of HAP in children.Method: A retrospective study was performed on 243 hospital-acquired children admitted to hospital from October 2015 to October 2017 in Ningxia.We recorded the following information of these children: sex,age,nationality,clinical manifestation,related auxiliary examination,onset time,onset seasons,the application of antibiotics,the results of bacterial culture and drug sensitivity test of the airway secretion.And the data was analyzed by SPSS17.0.Results: The male to female ratio of children with HAP in the study was 1.45: 1.The HAP patients aged from 29 days to 13 years old.The majority of the patients were younger than 3 years old,accounting for 77.0%.The Han nationality accounted for 69.1%,and the Hui was 29.61%.The late-onset HAP was more common in these patients(81.1%).The main season for the onset was winter,accounting for 41.6%,followed by autumn(27.6%),spring(22.2%),and summer(8.6%).71 strains of bacteria were identified in the study,among which Gram-negative bacteria accounted for 71.8%,Gram-positive bacteria accounted for 28.2%.In the bacteria of the late-onset HAP,the proportion of Gram-positive bacteria(54.5%)was a little higher than the proportion of Gram-negative bacteria(45.5%).While in the early-onset HAP,Gram-negative bacteria(76.7%)was much more than the Gram-positive bacteria,which just accounting for 23.3%.But there was no significant difference between the two groups(P < 0.05).The most common Gram-negative bacteria were Acinetobacter baumannii,Haemophilus influenzae,Escherichia coli,Klebsiella pneumoniae,respectively accounting for35.3%,15.7%,13.7%,11.8%.Among the 18 strains of Acinetobacter baumannii isolated,there were 12 strains of Multidrug-resistant Acinetobacter baumannii,accounting for 66.7%.The resistance rate of Acinetobacter baumannii to carbapenems and compound preparations of ?-lactamase inhibitors was as high as 77.8%.The main Gram-positive bacteria was Streptococcus pneumoniae,accounting for 80%,followed by Staphylococcus aureus(15%).There was no Gram-positive bacteria resistant to vancomycin.Conclusion: HAP in children is more common in infants who are younger than 3 years old,and mainly occurs in winter.The late-onset of HAP is also more common.The proportion of Multidrug-resistant Acinetobacter baumannii is high.It is necessary to detect the trend of bacterial resistance regularly and to use antibiotics rationally.