The distribution and drug resistance of pathogens of blood stream infection in pediatric surgery intensive care unit

Abstract

Objective To identify the pathogen distribution and antibiotics resistance of blood stream infection(BSI) in the pediatric surgery intensive care unit(PSICU). Methods The clinical data of 138 pediatric patients diagnosed with BSI from January 2011 to December 2015 were collected in PSICU, and the distribution of pathogens and drug resistance were retrospectively analyzed. Results The incidence of BSI was 3.88‰(138/35 524)in the five years, the majority of the BSI cases occurred under one year old, and the mortality was 13.77%(19/138). A total of 179 strains were isolated from blood samples of 138 patients, of which gram-positive bacteria, gram-negative bacteria and fungi accounted for 60.89%(109/179), 22.91%(41/179)and 16.20%(29/179)respectively.The most common gram-positive bacteria was coagulase-negative staphylococcus (84/179, 46.93%). The predominant gram-negative bacteria were Acinetobacter baumannii(15/179, 8.38%), Klebsiella pneumonia(12/179, 6.70%) and Escherichia coli(6/179, 3.35%). The rate of carbapenems-resistant Acinetobacter baumannii increased continuously in the study period.Non-albicans Candida was the most common fungi (14/179, 7.82%). The resistance rate of multi- drug resistant strains to carbapenems significantly increased. Conclusion The incidence of BSI in PSICU increases, and the mortality in children younger than one year is high.Better understanding of distribution of BSI pathogen could provide more effective antibiotic prescription. Key words: Pediatric surgery; Intensive care unit; Blood stream infection; Pathogens; Drug resistance,