To investigate the distribution and antimicrobial resistance profiles of bacterial infections among children in Xi’an Children’s Hospital, and to guide the reasonable use of antibiotics and precaution of multi-drug-resistant organisms (MDROs).

The clinical culture specimens of hospitalized children in Xi’an Children’s Hospital from January 2019 to December 2020 were isolated, and the distribution and drug resistance were analyzed, retrospectively, which were compared with the national surveillance data.

Total of 9 044 isolates were collected. The top-five pathogens were coagulase negative Staphylococci (CNS), Escherichia coli (Eco), Streptococcus pyogenes (Spy), Staphylococcus aureus (Sau) and Stenotrophomonas maltophilia (Sma), the proportions were 14.3%, 10.3%, 9.6%, 9.0% and 5.6%, respectively. The detection rates of methicillin-resistant Staphylococcus aureus (MRSA), erythromycin-resistant Streptococcus pneumoniae (ERSP) and Carbapenem-resistance Pseudomonas aeruginosa (CR-Pae) were 30.1%, 92.1%, and 14.2%, which were significantly lower than the national rates of 35.0%, 98.8% and 23.2% (χ² = 7.89, P = 0.01; χ² = 75.98, P < 0.001; χ² = 10.12, P < 0.001); while the rates of methicillin-resistant coagulase-negative staphylococci (MRCNS) and carbapenem-resistance Acinetobacter baumann (CR-Aba) were 81.8% and 68.9%, which were higher than the national rates of 76.4% and 54.0% (χ² = 4.78, P = 0.03; χ² = 11.53, P < 0.001). The average detection rate of MDROs was 10.2% (920/9 044), and the most common strains of MDROs were Eco [47.4% (436/920)], Sau [23.7% (218/920)] and Kpn [13.2% (121/920)]. The main sources of MODRs were pus [46.1% (424/920)], respiratory tract [28.9% (266/920)] and blood [11.1% (102/920)]. The strains were highly resistant to many kinds of antibiotics, some drug resistance rates were significantly different from the national surveillance levels. The prevalence of resistance of Sau and CNS against clindamycin were 67.8% (564/832) and 65.0% (724/1 114), respectively, which were significantly higher than those of the national rates [30.9% (2 645/8 561) and 25.5% (1 409/5 524)] , with significant differences (χ² = 458.8, 662.7, both P < 0.001); the resistance rates of Eco were as the following: 14.4% (135/935) to cefepime, 1.7% (16/935) to imipenem, 1.2% (11/935) to meropenem, which were significantly lower than those of the national levels [22.8% (2 181/9 567), 3.2% (306/9 567) and 4.2% (402/9 567)], respectively , with significant differences (χ² = 34.62, P < 0.001; χ² = 6.34, P = 0.01; χ² =20.64, P < 0.001); resistance rates of Aba to ceftazidime and imipenem were 65.2% (88/135) and 62.5% (84/135), significantly higher than those of national surveillance levels [53.4% (1 621/3 036) and 51.9% (1 576/3 036)] (χ² = 7.23, P = 0.01; χ² = 5.51, P = 0.02); the resistance rates of Pae to piperacillin, ceftazidime, cefepime and meropenem were 8.6% (20/233), 7.7% (18/233), 2.7% (6/233) and 8.7% (20/233), respectively, significantly lower than those of the national surveillance rates [15.2% (508/3 344), 14.0% (468/3 344), 10.2% (341/3 344) and 20.0%(669/ 3 344)], with significant differences (χ² = 7.56, P = 0.01; χ² = 7.29, P = 0.01; χ² = 14.45, P < 0.001; χ² = 18.27, P < 0.001).

The distribution and rates of antimicrobial resistance profiles of bacterial in our hospital were different from the national level, especially the resistance rates of Sau and CNS to clindamycin, Eco to cefepime and carbapenem antibiotics, Aba to ceftazidime and imipenem, Pae to β-lactam and carbapenem antibiotics differed significantly from the national surveillance levels. Therefore, the prevention and control of MRCNS and CR-ABA should be strengthened, and antibiotics should be used rationally according to the characteristics of our region to reduce the infection rate and nosocomial infection.