Distribution and drug resistance of pathogens from blood culture of children in intensive care unit based on PIC database

OBJECTIVE To investigate the distribution and drug resistance of pathogens isolated from the children with bloodstream infection in pediatric intensive care unit (PICU) so as to provide guidance for empirical clinical treatment of infections.

METHODS Based on the Pediatric Intensive Care Database (PIC, http://pic.nbscn.org), the etiological data were collected from the PICU children of Children′ s Hospital, Zhejiang University School of Medicine by R software in 2010-2019 and were retrospectively analyzed. The species, distribution and drug resistance of the pathogens isolated from the children were observed.

RESULTS Totally 991 strains of pathogens were isolated, 727 (73.36%) of which were gram-positive bacteria, 213 (21.49%) were gram-negative bacteria, and 51 (5.15%) were fungi. Staphylococcus epidermidis (320 strains, 32.29%) was the predominant species of the gram-positive bacteria, followed by Staphylococcus hominis(118 strains, 11.91%), Staphylococcus capitis (55 strains, 5.55%) and Enterococcus faecium (Group D, 33 strains, 3.33%); Klebsiella pneumoniae (59 strains, 5.95%), Escherichia coli (58 strains, 5.85%), Acinetobacter baumannii (25 strains, 2.52%) and Pseudomonas aeruginosa (18 strains, 1.82%) were the major species of gram-negative bacteria. The analysis of drug resistance showed that the gram-positive bacteria were generally resistant to β lactams and maintained sensitive to vancomycin and linezolid; the gram-negative bacteria showed high drug resistance rates, especially, A. baumannii and P. aeruginosa, showed multi-drug resistance.

CONCLUSIONS The gram-positive bacteria are dominant among the pathogens isolated from the PICU children with bloodstream infections. The empirical treatment should be performed based on the distribution and drug resistance data of the pathogens, and sensitive drugs should be chosen for optimization of the treatment regimen.