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. 2021 Apr 15;13(4):3309-3315.
eCollection 2021.

The drug resistance of multidrug-resistant bacterial organisms in pediatric pneumonia patients

Xianbo Chen  1 , Danfeng Pan  2 , Yongzheng Chen  1
Affiliations

The drug resistance of multidrug-resistant bacterial organisms in pediatric pneumonia patients

Xianbo Chen et al. Am J Transl Res. .

Abstract

Objective: This study aimed to investigate the distribution of multidrug-resistant organisms in pediatric patients with infectious pneumonia and to analyze their resistance and risk factors.

Methods: Pediatric patients infected with five MDROs (MRSA, MDR-PA, MDRAB, ESBL KP, and ESBL E. coli) and five sensitive bacteria (MSSA, PA, AB, KP, and E. coli) were recruited as the study cohort. The distribution of the MDROs and the risk factors for MDRO-infected pneumonia were investigated. The two groups' treatment costs, hospitalization times, and prognoses were compared.

Results: A total of 219 children were included, including 3 cases of mixed infections with MDRO and sensitive bacteria (1.37%), 110 cases of MDRO infections (50.23%), and 106 cases of sensitive bacterial infections (48.40%). Imipramine was sensitive to MDR-PA, MDRAB, ESBL KP, and ESBL E. coli, and vancomycin was sensitive to MRSA. A logistic regression model and a multifactorial analysis showed that ICU treatment, mechanical ventilation, arterial and venous intubation, fiberoptic bronchoscopy, concomitant chronic lung disease, and chronic cardiovascular disease were the independent risk factors for MDRO (P < 0.05). The hospitalization times, the treatment costs, and the 30-day mortality rate of the children in the MDRO group were significantly higher than they were in the children infected with sensitive bacteria (P < 0.05).

Conclusion: Vancomycin or imipenem may result in good clinical outcomes in children treated in the ICU subject to mechanical ventilation, arterial and venous intubation, fiberoptic bronchoscopy, the overuse of antimicrobial drugs, and children with concomitant chronic lung disease or chronic cardiovascular disease.

Keywords: MDROs; drug resistance; infectious pneumonia; pediatric patients.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Distribution of the pathogenic bacteria detected in the two groups of children. Our analysis showed that the proportions of MRSA, MDR-PA, MSRAB, ESBL KP, and ESBL E. coli in the MDRO group (A) were 19.09%, 18.18%, 17.27%, 20.91%, and 24.55%, respectively. The proportions of MSSA, PA, AB, KP, and E. coli in the sensitive bacteria group (B) were 18.93%, 17.98%, 16.09%, 9.46%, and 37.53%, respectively.
Figure 2
Figure 2
Comparison of the differences in the outcomes between the MDRO group and the sensitive bacteria group. The hospitalization times (A), treatment costs (B), and 30-day mortality rate (C) of the children in the sensitive bacteria group were significantly lower than the 30-day mortality rate of the children in the MDRO group (P < 0.05) # P < 0.05 compared with the sensitive bacteria group.
Figure 3
Figure 3
Comparison of the 30 day case fatality rate between the two groups. The 30 day mortality rate of the sensitive bacteria group was significantly lower than it was in the MDRO group.
See this image and copyright information in PMC

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