title: [Changes of drug-resistance of Pseudomonas aeruginosa in pediatric intensive care unit].
abstract: OBJECTIVE
  Pseudomonas aeruginosa is an important cause of nosocomial infection, severe sepsis and death which associated with a trends of rising rates of resistance to a broad array of antimicrobial agents. To explore a feasible treatment protocol for such patients, we analyzed the susceptibility patterns of Pseudomonas aeruginosa in pediatric intensive care unit (PICU).
  
  
  METHODS
  The age distribution, outcome of patients, sources of strains and susceptibility patterns of Pseudomonas aeruginosa in PICU from Jan 1, 2007 to Dec 31, 2011 were analyzed. Susceptibility to amikacin, piperacillin/tazobactam, aztreonam, ampicillin, ciprofloxacin, imipenem, meropenem, cefepime, cefoperazone, cefotaxime, ceftriaxone, ceftazidime, cefoperazone/sulbactam, cephazolin, cefuroxime, and polymyxin were determined by the disk-diffusion technique (K-B test method) and broth microdilution. P. aeruginosa ATCC 27853 was used as reference strain.
  
  
  RESULTS
  Seventy-five patients were Pseudomonas aeruginosa positive. 26(34.7%) were < 6 m, 49 (65.4%) were < 2 y. The percentages of cases who were Pseudomonas aeruginosa positive in different age groups in the same time was basically similar; 18 (24.0%) cases died. Pseudomonas aeruginosa accounted for 10.9% of G(-) germs, 6.5% of all pathogens in 2010 - 2011. Of the 126 strains, 83 (65.9%) were from sputum sample, 31 (24.6%) were from catheter sample of tracheal cannula, 10 (7.9%) were from blood sample and 2 (1.6%) were from secretion sample. The sensitivity to antibiotics of Pseudomonas aeruginosa in pediatric common treatments was 72.4% to cefoperazone/sulbactam, 71.5% to meropenem, 48.4% to imipenem, 66.7% to ceftazidime, 49.2% to piperacillin/tazobactam. Absolute resistance to ampicillin, cephazolin, cefuroxime and cefotaxime. Multiple-drug resistance was still severe, but a decreasing tendency was observed, 90.5% in 2007, 81.3% in 2008, 51.1% in 2009, 53.8% in 2010, 33.3% in 2011. Pan-drug resistance in different years was similar, 12.5% in 2008, 2.2% in 2009, 7.7% in 2010, 6.7% in 2011.
  
  
  CONCLUSIONS
  The condition of drug resistance of Pseudomonas aeruginosa was still rigorous, we should conduct surveillance and prevent abusing antibiotics in order to avoid exacerbating drug resistance. We should improve testing technique, early and appropriate empirical antibiotics therapy is crucial according to clinical experience and antibiotic sensitivity. The effective treatment of P. aeruginosa is paramount to prevent multidrug resistance. The use of combination therapies for P. aeruginosa infection has been a long-advocated practice. To prevent hospital acquired cross infection, health care workers must pay close attention to hand sanitation and sterile operation strictly.
authors.affiliation: Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Li-jie
authors.initials: LJ
authors.lastname: Wang
authors.forename: Ying
authors.initials: Y
authors.lastname: Sun
authors.forename: Wen-liang
authors.initials: WL
authors.lastname: Song
authors.forename: Zhi-jie
authors.initials: ZJ
authors.lastname: Zhang
authors.forename: Chun-feng
authors.initials: CF
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000667:Ampicillin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002437:Cefazolin / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000382:microbiology* / Q000517:prevention & control; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D015378:Imipenem / Q000494:pharmacology; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D008826:Microbial Sensitivity Tests; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; D015378:Imipenem; D000667:Ampicillin; D002437:Cefazolin