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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