Epidemiology and drug resistance analysis of bloodstream infections in intensive care unit from a children's medical center in eastern China for six consecutive years

Abstract

Abstract Background Children with severe basic diseases and low immunity in the intensive care unit (ICU) are usually in critical condition. It is important to help clinicians choose the appropriate empirical antibiotic therapy for clinical infection control. Methods 281 children with bloodstream infection (BSI) were retrospectively analyzed. Statistical software was used to compare and analyse the basic data, pathogenic information, and drug resistance of the main bacteria. Results A total of 328 strains were detected, including gram-positive bacteria (223, 68%), mainly including coagulase-negative staphylococci (CoNS), gram-negative bacteria (91, 27.7%), fungi (14, 4.3%). There were 243 cases of single pathogen infection and 38 cases of mixed pathogen infection. Results of binary logistic regression analysis showed that lengths of hospitalization of 0～<30d was an independent risk factor for mixed infection, and length of hospitalization of 15～<60d was an independent risk factor related to death. Compared with Escherichia coli, the proportion of extended-spectrum β-lactamases (ESBLs) was higher producing by Klebsiella pneumoniae, and its resistance to some β-lactamides, quinolones antibiotics were lower. 27 isolates of multi-drug resistant (MDR) bacteria were detected, among which carbapenem-resistant Acinetobacter baumannii (CRAB) accounted for the highest proportion (13, 48.2%). Conclusion CoNS was the principal pathogen of BSI in the intensive care unit (ICU) of children, and Escherichia coli was the most common gram-negative pathogen. It is necessary to continuously monitor patients with positive blood culture, pay special attention to the detected MDR bacteria, and strengthen the application management of antibiotics and the prevention and control of nosocomial infection.