Analysis of epidemic distribution and drug resistance of pathogens in PICU

Wu Song ,Tianhe Zhang ,Lijie Wang ,Dongyue Ke ,Zhijie Zhang ,Yu Sun ,Xiaojun Guo

doi:10.3760/cma.j.issn.1673-4912.2014.01.008

Abstract

Objective To investigate the epidemic distribution and drug resistance of pathogens in PICU in Shengjing Hospital of China Medical University. Methods We retrospectively analyzed the pathogens isolated from patients in PICU from Jan 2010 to Dec 2011.The specimens were from sputum, bloodstream, tube(such as endotracheal tube, deep vein catheterization), urine, cerebrospinal fluid and so on. Results Total of 471 pathogens were isolated from 349 patients, and Gram-negative bacilli, Gram-positive cocci and fungi accounted for 60.5%(285/471), 35.7%(168/471), 3.8%(18/471) respectively.The top 5 pathogens were the followings: Acinetobacter baumannii 88 strains (18.7%), Klebsiella pneumonia 70 strains (14.9%), Pseudomonas aeruginosa 51 strains (10.8%), Stroptococci pneumonia 45 strains (9.6%) and Escherichia coli 43 strains (9.1%); the rate of extended-spectrum beta-lactamase-producing strains of Klebsiella pneumonia and Escherichia coli were 65.7%(46/70)and 37.2%(16/43) respectively, and the resistant rates of them to Cephalosporin antibiotics were more than 85.0%.There was severe condition of multi-drug resistance for non-fermentation bacteria, especially for Acinetobacter baumannii.The resistant rate of Acinetobacter baumannii to most Cephalosporin antibiotics was more than 70%, including 78 multidrug-resistant strain(88.7%) and 58 pandrug-resistant strain(66.0%). In Gram-positive cocci, 31.8%of staphylococcus aureus and 53.3%of coagulase negative staphylococci were Methicillin resistant staphylococcus aureus (7 strains) and Methicillin resistant coagulase negative staphylococci (16 strains), which were 100% sensitive to Vancomycin. Conclusion Gram-negative bacilli are the main pathogens in PICU, and drug resistance rate is high.Recently the multi-drug resistance is increasing.So it is important to carry out surveillance of pathogens distribution and bacterial resistance. Key words: Pediatric intensive care unit; Bacterial distribution; Drug resistance; Antibiotics

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