Wang Li-Jie, Song Wen-Liang, Sun Ying, Liu Chun-Feng, Zhang Zhi-Jie
Shengjing Hospital of China Medical University, Shenyang, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2013 Feb;15(2):117-20.
To study the clinical characteristics of Pseudomonas aeruginosa (PA)-positive children in the pediatric intensive care unit, and to provide a basis for early diagnosis and reasonable treatment of PA infection.
The clinical data of 62 children infected with PA in the pediatric intensive care unit were retrospectively reviewed,including age, affected organs, fever duration, hospital stay duration, mechanical ventilation duration, prognosis, underlying diseases, mortality, culture results and drug sensitivity test results.
Of the 62 PA-positive children, 25 (40%) were aged under 6 months and 47 (76%) under 2 years, with a median age of 28.8 months. Twenty-seven showed one positive result for sputum culture or endotracheal tube aspirates culture, 3 showed one positive result for blood culture, and 32 showed more than two positive results for blood, sputum or endotracheal tube aspirates cultures. On average, 2.8 organs were affected in each patient, with the respiratory system involved most frequently (58 patients, 94%). The mean fever duration was 7.3 days and the mean hospital stay duration was 34.2 days. In the 62 patients, 35 (57%) were cured and 17 (27%) died. Mechanical ventilation was administered to 51 patients (82%) for a mean duration of 13.4 days. Fifty-one patients (82%) had underlying diseases. The 17 (27%) children who died had a mean age of 17.4 months and a mean CRP level of 52.6 mg/L; 14 of them had increased or normal white blood cell count, and 3 had a decreased white blood cell count.The antibiotic sensitivity of PA was 72.6% for cefoperazone/sulbactam, 70.8% for meropenem, 49.1% for imipenem, 65.1% for ceftazidime, and 44.3% for piperacillin/tazobactam. There was complete resistance to cephazolin, cefuroxime and cefotaxime.
The children under 2 years are prone to PA infection. Respiratory system involvements are common. Most of children infected with PA suffer from underlying diseases.The sensitivity of PA to common antibiotics is not high.
研究儿科重症监护病房中铜绿假单胞菌（PA）阳性患儿的临床特征，为PA感染的早期诊断及合理治疗提供依据。
回顾性分析儿科重症监护病房62例PA感染患儿的临床资料，包括年龄、受累器官、发热持续时间、住院时间、机械通气时间、预后、基础疾病、死亡率、培养结果及药敏试验结果。
62例PA阳性患儿中，25例（40%）年龄小于6个月，47例（76%）年龄小于2岁，中位年龄为28.8个月。27例痰培养或气管内吸出物培养呈单次阳性，3例血培养呈单次阳性，32例血、痰或气管内吸出物培养呈两次以上阳性。每位患者平均受累2.8个器官，其中呼吸系统受累最为常见（58例，94%）。平均发热持续时间为7.3天，平均住院时间为34.2天。62例患者中，35例（57%）治愈，17例（27%）死亡。51例（82%）患者接受了机械通气，平均持续时间为13.4天。51例（82%）患者有基础疾病。17例（27%）死亡患儿的平均年龄为17.4个月，平均CRP水平为52.6mg/L；其中14例白细胞计数升高或正常，3例白细胞计数降低。PA对头孢哌酮/舒巴坦的药敏率为72.6%，对美罗培南为70.8%，对亚胺培南为49.1%，对头孢他啶为65.1%，对哌拉西林/他唑巴坦为44.3%。对头孢唑林、头孢呋辛和头孢噻肟完全耐药。
2岁以下儿童易发生PA感染。呼吸系统受累常见。大多数PA感染患儿患有基础疾病。PA对常用抗生素的敏感性不高。
