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Microbiological profiles and antimicrobial resistance patterns of pediatric bloodstream pathogens in China, 2016–2018

European Journal of Clinical Microbiology & Infectious Diseases volume 40, pages 739–749 (2021)Cite this article

Abstract

Objectives

This study aimed to investigate the microbiological profiles and antimicrobial resistance patterns of bloodstream pathogens in Chinese children.

Methods

This retrospective study was conducted at 13 tertiary hospitals in China during 2016–2018. The first bloodstream isolates of the same species from one pediatric patient < 18 years were included to this study for analysis. Antimicrobial susceptibility testing was determined based on minimum inhibitory concentrations or Kirby-Bauer disk diffusion methods according to the 2018 Clinical and Laboratory Standards Institute guidelines.

Results

Overall, 9345 nonduplicate bloodstream isolates were collected. Top 10 pathogens included Coagulase-negative staphylococcus (CoNS) (44.4%), Escherichia coli (10.2%), Klebsiella pneumoniae (5.9%), Staphylococcus aureus (5.0%), Streptococcus pneumoniae (4.9%), Pseudomonas aeruginosa(2.8%), Enterococcus faecium (2.7%), Stenotrophomonas maltophilia (2.4%), Salmonella spp. (2.3%), and Streptococcus agalactiae (2.0%). The commonest pathogens apart from CoNS in age group 0–28 days, 29 days–2 months, 3-11 months, 1–5 years, and ≥ 5 years were Escherichia coli (17.2%), Escherichia coli (14.0%), Escherichia coli (7.9%), Streptococcus pneumoniae (10.7%) ,and Staphylococcus aureus (13.6%), respectively. The overall prevalence of extended-spectrum β-lactamases-producing Enterobacteriaceae, carbapenem-resistant Klebsiella pneumoniae, carbapenem-resistant Acinetobacter baumannii, and carbapenem-resistant Pseudomonas aeruginosa were 41.4, 28.4, 31.7, and 5.6%, respectively. The overall prevalence of methicillin-resistant Staphylococcus aureus, penicillin-resistant Streptococcus pneumoniae and vancomycin-resistant Enterococcus was 38.1, 28.3, and 0.7%, respectively.

Conclusions

The major bacterial pathogens have differences in different age groups, ward types, and regions in Chinese children, and the commonest causing microorganism was the Escherichia coli, especially in neonates and infants. High prevalence of important resistant phenotypes is of a serious concern.

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Acknowledgment

We sincerely thank Prof. Hong Zhao, the secretary of China Society of Infectious Diseases, for her help with the program initiation. We thank the members of the collaborative working group of pediatric subgroups of China Society of Infectious Diseases for their collecting the data for this study. We sincerely thanks Dr. Benedikt D. Huttner, who is an infectious diseases specialist of Division of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, for his valuable suggestion on this study protocol before the initiation of this study.

Author information

Author notes

  1. Yue Qiu, Junwen Yang and Yiping Chen contributed equally to this work.

Affiliations

  1. Department of Infectious Diseases, Children’s Hospital of Fudan University, 399 Wanyuan Road, Shanghai, 201102, China

    Yue Qiu & Mei Zeng

  2. Department of Microbiology Laboratory, Children’s Hospital Affiliated to Zhengzhou University (Henan Children’s Hospital), Zhengzhou, China

    Junwen Yang

  3. Department of Pediatrics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China

    Yiping Chen

  4. Department of Microbiology Laboratory, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China

    Jinhong Yang

  5. Department of Infection Diseases, Children’s hospital of Jiangxi Province, Nanchang, China

    Qingxiong Zhu & Chunhui Zhu

  6. Department of Hepatology, Hunan Children’s Hospital, Changsha, China

    Shuangjie Li

  7. Department of Infection Diseases, Hunan Children’s Hospital, Changsha, China

    Jing Liu

  8. Department of Pediatrics, Sichuan University West China Second Hospital, Chengdu, China

    Chaomin Wan & Yu Zhu

  9. Department of Infections Disease, Guangzhou Women and Children’s Medical Center, Guangzhou, China

    Minxia Chen & Yi Xu

  10. Department of Pediatric, Gastroenterology and Infectious Diseases, Qingdao Women and Children’s Hospital, Qingdao, China

    Jianning Tong & Rui Li

  11. Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China

    Qingwen Shan

  12. Department of infectious diseases, Hainan Women and Children’s Medical Center, Haikou, China

    Daojiong Lin & Shouye Wu

  13. Department of infectious diseases, Xiamen Children’s Hospital, Xiamen, China

    Zhiqiang Zhuo & Caihong Wang

  14. Department of Infectious Diseases, Hangzhou Children’s Hospital, Hangzhou, China

    Shiyong Zhao & Zhenghong Qi

  15. Department of Infectious Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China

    Xiaofeng Sun & Bieerding Maihebuba

  16. Department of Pharmacy, The fourth Hospital of Baotou, Baotou, China

    Chunmei Jia & Huiling Gao

  17. Department of Emergency, Henan Children’s Hospital Affiliated to Zhengzhou University, 33, Longhu Outer Ring East Road, Zhengzhou, 450018, China

    Yibing Cheng

Authors
  1. Yue Qiu
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  2. Junwen Yang
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  3. Yiping Chen
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  4. Jinhong Yang
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  5. Qingxiong Zhu
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  20. Shiyong Zhao
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Consortia

On behalf of the Collaborative Working Group of the Pediatric Subgroup of the China Society of Infectious Diseases

Corresponding authors

Correspondence to Yibing Cheng or Mei Zeng.

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All authors declared no potential conflicts of interest to disclose.

Ethical approval

This study was reviewed and informed consent from patients was not required by the ethics committee because there was no contact with patients and all data were de-identified.

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Qiu, Y., Yang, J., Chen, Y. et al. Microbiological profiles and antimicrobial resistance patterns of pediatric bloodstream pathogens in China, 2016–2018. Eur J Clin Microbiol Infect Dis 40, 739–749 (2021). https://doi.org/10.1007/s10096-020-04069-2

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  • DOI: https://doi.org/10.1007/s10096-020-04069-2

Keywords

  • Bloodstream infection
  • Microbiology
  • Antimicrobial resistance
  • Children