Antimicrobial Resistance Patterns and Epidemiological Distribution of Pathogenic Bacteria in the Pediatric Intensive Care Unit at Beijing Children's Hospital: A Decade-Long Retrospective Analysis (2014-2023).

Objective: This study aimed to analyze the distribution characteristics and changes in antimicrobial resistance of pathogens in the Pediatric Intensive Care Unit (PICU) of Beijing Children's Hospital from 2014 to 2023 to guide the rational use of antibiotics and provide a scientific basis for hospital infection prevention and control, as well as public health policy formulation. Methods: A retrospective cohort design was used to systematically analyze the clinical data and antibiotic sensitivity results of 4,468 children aged 0-17 years who were admitted to the PICU of Beijing Children's Hospital between 2014 and 2023. Results: 6,079 strains of pathogenic bacteria were cultured and isolated. There were 4,276 strains of Gram-negative bacteria, including Acinetobacter baumannii (20.0%), Pseudomonas aeruginosa (15.2%), and Klebsiella pneumoniae (12.9%); There were 1,803 Gram-positive bacteria, including Staphylococcus aureus (11.3%) and coagulase-negative Staphylococci (CoNS) (7.9%). Between 2014 and 2023, the number of detected Gram-negative and Gram-positive bacteria showed a fluctuating upward trend. A. baumannii showed a resistance rate of over 70% to most antibiotics, P. aeruginosa exhibited a relatively high resistance rate to carbapenems, and Escherichia coli demonstrated a high resistance rate to third-generation cephalosporins, but a low resistance rate to carbapenems. Methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococci (MRCNS) were highly resistant to most antibiotics but remained highly sensitive to linezolid and vancomycin. Carbapenem-resistance (CR) and difficult-to-treat resistance (DTR) phenotypes of K. pneumoniae showed a marked upward trend. In contrast, E. coli, P. aeruginosa, and A. baumannii exhibited fluctuating or relatively stable resistance to extended-spectrum cephalosporins (ECR) and fluoroquinolones (FQR). Conclusion: This study revealed the distribution and antibiotic resistance trends of pathogens in the PICU of Beijing Children's Hospital, providing important evidence for empirical anti-infective treatment in clinical practice.