JMI Laboratories, North Liberty, Iowa, USA.
JMI Laboratories, North Liberty, Iowa, USA.
Diagn Microbiol Infect Dis. 2020 Oct;98(2):115108. doi: 10.1016/j.diagmicrobio.2020.115108. Epub 2020 Jun 13.
Studies evaluating large series of pediatric patients with bloodstream infections (BSIs) are scarce. We evaluated the frequency and antimicrobial susceptibility of organisms isolated from pediatric patients with BSI and therapeutic options for BSI caused by multidrug-resistant (MDR) organisms. A total of 2423 organisms were consecutively collected from 33 US medical centers between 2014 and 2018, and susceptibility was tested by reference broth microdilution methods. Isolates with an extended-spectrum β-lactamase phenotype were screened for β-lactamase genes. Overall, 40.2% of organisms were Gram-negative bacteria, 57.0% Gram-positives, and 2.8% Candida spp. The 5 most common organisms were Staphylococcus aureus (26.0%), Escherichia coli (13.0%), coagulase-negative staphylococci (8.3%), Enterococcus faecalis (7.1%), and Klebsiella pneumoniae (6.9%). Among S. aureus, 26.0% were oxacillin-resistant and 99.8% were susceptible to ceftaroline (MIC, 0.25/0.5 mg/L). Enterobacterales and Pseudomonas aeruginosa isolates combined represented >85% of Gram-negative bacteria, and all isolates (100.0%) were susceptible to ceftazidime-avibactam.
评估小儿血流感染（BSI）大系列患者的研究很少。我们评估了从小儿 BSI 患者中分离的病原体的频率和药敏性，以及耐多药（MDR）病原体引起的 BSI 的治疗选择。2014 年至 2018 年间，我们从美国 33 家医疗中心连续采集了 2423 株病原体，并通过参考肉汤微量稀释法进行了药敏性测试。对具有扩展谱β-内酰胺酶表型的分离物进行了β-内酰胺酶基因筛查。总的来说，40.2%的病原体为革兰氏阴性菌，57.0%为革兰氏阳性菌，2.8%为念珠菌属。最常见的 5 种病原体为金黄色葡萄球菌（26.0%）、大肠杆菌（13.0%）、凝固酶阴性葡萄球菌（8.3%）、粪肠球菌（7.1%）和肺炎克雷伯菌（6.9%）。金黄色葡萄球菌中，26.0%为耐苯唑西林，99.8%对头孢他啶-克拉维酸敏感（MIC，0.25/0.5mg/L）。肠杆菌科和铜绿假单胞菌的分离物联合占革兰氏阴性菌的>85%，所有分离物（100.0%）均对头孢他啶-阿维巴坦敏感。
