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_50/90, 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.

评估大量血流感染 (BSI) 儿科患者的研究很少。我们评估了从患有 BSI 的儿科患者中分离出的微生物的频率和抗菌药物敏感性，以及由多重耐药 (MDR) 微生物引起的 BSI 的治疗方案。 2014年至2018年间从美国33个医疗中心连续收集了总共2423个微生物，并通过参考肉汤微量稀释方法进行了敏感性测试。对具有超广谱 β-内酰胺酶表型的分离株进行了 β-内酰胺酶基因筛选。总体而言，40.2% 的微生物为革兰氏阴性菌，57.0% 为革兰氏阳性菌，2.8%为念珠菌。最常见的5种微生物是金黄色葡萄球菌（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%）。在金黄色葡萄球菌中，26.0%对苯唑西林耐药，99.8%对头孢洛林敏感（MIC _50/90，0.25 /0.5 mg/L）。肠杆菌和铜绿假单胞菌分离株合计占革兰氏阴性菌的 85% 以上，所有分离株 (100.0%) 对头孢他啶-阿维巴坦敏感。