Anlysis Of Common Gram-negative Bacterial Infections And Their Drug Resistance In PICU

Objective To provide information for clinical prevention and treatment of PICU,we analyzed the common Gram-negative bacilli infection and their drug resistance in PICU.Methods Retrospective analysis of PICU children,who were isolated and cultured out of Gram-negative bacteria,and hospitalized from January 2013 to December 2016 in our hospital.Results A total of 757 strains of pathogenic bacteria were isolated from picu in recent 4 years,of which 509 were Gram-negative bacteria(67.2%).The top 5 Gram-negative strains were Pseudomonas aeruginosa,Acinetobacter baumannii,Stenotrophomonas maltophilia,Klebsiella pneumoniae,and Escherichia coli.The positive specimens were mainly from respiratory tract,including 251 cases of sputum(49.3%;176 cases of endotracheal intubation,accounting for 70.1% of the sputum),114 cases of tracheal tip(22.4%),3 cases of alveolar lavage fluid(0.6%),49 cases of blood(9.6%),and 13 cases of arteriovenous catheterization tip(2.6%).The drug resistance of the top 5 Gram-negative bacteria was analyzed.The resistance rates of Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella pneumoniae and Escherichia coli to ampicillin,ceftriaxone and cefazolin were generally high.Pseudomonas aeruginosa,Klebsiella pneumoniae and Escherichia coli have low resistance to enzyme inhibitor antibiotics and are generally sensitive to imipenem and meropenem.Acinetobacter baumannii has a higher rate of resistance to common antibiotics than other strains,and the isolation rate of multidrug resistant strains exceeds 50%.Stenotrophomonas maltophilia is still sensitive to ceftazidime,levofloxacin,and cotrimoxazole.In the 4 years,97 strains(19.05%)of multidrug-resistant Gram-negative bacteria were isolated,including 7 strains of carbapenem-resistant Penicillium bacteria,5 strains of Klebsiella pneumoniae,1 strain of E.coli and 1 strain of Enterobacter cloacae.There were 15 strains of extensively resistant strains(2.94%),including 14 strains of Acinetobacter baumannii and 1 strain of Enterobacter cloacae.Conclusions The bacterial infections of children with PICU were mainly Gram-negative bacteria.The top 5 were Pseudomonas aeruginosa,Acinetobacter baumannii,Stenotrophomonas maltophilia,Klebsiella pneumoniae and Escherichia coli.21.99% of multi-drug resistant and extensively drug-resistant strains indicated that the drug resistance of gram-negative bacteria is still severe and should be taken seriously by clinical staff.