Analysis Of Clinical Distribution And Drug Resistance Of Escherichia Coli In Children In Baoding

Objective : To summarize the clinical distribution characteristics of children infected with Escherichia coli(E.coli)in Baoding,and to analyze the drug resistance of antibiotics,especially the strain of extended spectrum beta-lactamases strain(ESBLs),and to improve the level of diagnosis and treatment,so as to provide evidence for rational use of antibiotics in clinic.Methods:The clinical data and antimicrobial susceptibility data of 787 children with E.coli infection from January 1,2014 to December 31,2016 were selected from children in-hospital in 0-18 years in Department of internal medicine and pediatric surgery in Baoding children’s hospital.Summarize the children’s gender,age,disease location,severity,complications,prognosis,history and laboratory indexes: blood routine,urine,sputum,urine,pus,blood and cerebrospinal fluid culture,cerebrospinal fluid routine biochemical smear detection,chest X-ray,abdominal ultrasound,cranial CT,ranial magnetic resonance imaging(MRI)etc..Inclusion criteria: selected children in-hospital in Baoding children’s Hospital from January 1,2014 to December 31,2016.The children were diagnosed according to "Zhu Futang Practical Pediatrics" eighth edition of pneumonia,bronchitis and upper respiratory tract infection,urinary tract infection,appendicitis,perianal abscess,sepsis,suppurative meningitis diagnostic criteria.The children’s sputum,pus,urine,throat swabs,blood and cerebr-ospinal fluid specimens(the top six of the positive number of Escherichia coli specimens)collected from the medical staff under aseptic operation,were sent to the bacteriological room by the special person.Exclusion criteria: Repetitive specimens were separated from the same part of the same person,and Screening and excluding samples of different strains from the same or different parts of the same person.Results:There were 979 strains of bacterial culture in E.coli infected children,192 strains of repeated E.coli strains,There were 787 cases totally,including male 561 cases and female 226 cases.The ratio male to female was 2.5:1.the age ranged from 6 hours to 18 years of age,of which 101 cases(12.8%)to 28d;458(58.2%)to 1 years;84 cases(10.7%).73 cases(9.3%)to 6 years old;71 cases(9%)to 18 years old.The ~1 year old was the highest detection rate of E.coli(P<0.005).Clinical disease with bronchial pneumonia,accounting for 307 cases(39%),followed by abdominal infection in 209 cases(26.56%),106 cases of urinary tract infection(13.47%),72 cases with bronchitis(9.15%),49 cases of upper respiratory tract infection(6.23%),sepsis were 36 cases(4.07%)and suppurative meningitis in 13 cases(1.65%).54 of them had basic diseases,including congenital heart disease,tracheobronchial malformation,bronchial dysplasia,chromosomal disease,anemia,urinary system malformation and so on.Among 787 cases,698 cases(88.7%)were cured,74 cases(9.4%)were improved,9 cases(1.1%)had Complications in treatment,3 cases of epilepsy,1 cases of ventricular inflammation,2 cases of obstructive hydrocephalus,2 cases of subdural effusion,and 1 cases of subdural hematoma.There were 6 cases of death(0.8%).The ESBLs strains were detected in 394 cases(394/787,50.1%),all of which were multiple resistant bacteria(MDR).The detection rate was almost unchanged in the past 3 years,and the difference was not statistically significant.(P>0.05).Drug sensitivity results: E.coli maintained good sensitivity to meropenem,imipenem,Amikacin,piperacillin tazobactam,ceftaettan and Amikacin,while the drug resistance rate of ceftriaxone and cefotaxime was higher.The sensitivity rate of ceftazidime,cefepime,aztreonam and ciprofloxacin ranged from 23.8% to 37.4%.Conclusion : Escherichia coli in children is a common pathogenic bacteria.and the relative susceptible parts are respiratory system and abdominal cavity.Severe cases are common in sepsis and suppurative meningitis.ESBLs strains are common.The clinicians should pay attention to the results of drug sensitivity,strictly grasp the indications of antimicrobial drugs and reduce the resistance of pathogenic bacteria.