Current Status Of Antimicrobial Therapy And Antimicrobial Susceptibility Analysis In Children With Invasive Pseudomonas Aeruginosa Infection

Objective:To analyze the current antimicrobial therapy for children with invasive Pseudomonas aeruginosa infection(IPAI)and antimicrobial susceptibility of the invasive Pseudomonas aeruginosa(IPA)isolates,so as to provide reference for treatment for IPAI children.Methods:The clinical data of 61 IPAI children who admitted from January 2014 to March 2019 and the results of antimicrobial susceptibility of 61 IPA isolates were analyzed retrospectively.We analyzed the current antimicrobial therapy for IPAI children.The clinical characteristics and outcomes were compared between 48 patients who empirically treated with anti-pseudomonal antibiotics and 13 patients empirically treated with non-anti-pseudomonal antibiotics.We compared the clinical characteristics and outcomes between 27 patients who were empirically treated with anti-pseudomonal carbapenem and 19 patients who were empirically treated with anti-pseudomonal penicillin or cephalosporin or theβ-lactamase inhibitor combinations.Results:In the 61 patients(37 boys;24 girls)with a median age of2.13 years(0.58-9.14 years),26 patients(42.62%)had PRISM Ⅲ score≥10.12 patients(19.67%)died in-hospital,15 patients(24.59%)had septic shock.The hospitalization days after infection in the non-anti-pseudomonal therapy group was significantly longer than that in the anti-pseudomonal therapy group(P=0.042),while there was no significant difference in PICU admission,hospital mortality and septic shock incidence.The PICU admission,hospital mortality,septic shock incidence and hospitalization days after infection were similar between empirical carbapenem therapy and non-carbapenem therapy patients(P(29)0.05).The susceptibility of IPA isolates to piperacillin-tazobactam,ceftazidime and cefepime was85%-90%,and to imipenem and meropenem was both 90%-95%.Conclusions:IPA isolates in Chongqing had high susceptibility to commonly used anti-pseudomonal antibiotics.Penicillin or cephalosporin or the β-lactamase inhibitor combinations may be used as the first choice for empirical treatment for children with IPAI.