Objective To investigate the distribution and resistance profile of bacterial isolates in Shanghai Children's Hospital. Methods Antimicrobial susceptibility of all isolates was determined by Kirby-Bauer disk diffusion method according to 2016 CLSI standard. The data were analyzed by WHONET 5.6 software. Results A total of 23 259 non-duplicate strains were isolated from 2011 to 2016, including 10 885(46.8％)gram-postive cocci and 12 374(53.2％)gram-negative bacilli. The average prevalence of methicillin-resistant S. aureus(MRSA)and coagulase-negative Staphylococcus(MRCNS)was 35.8％ and 82.2％, respectively. The prevalence of MRSA rose from 27.4％ in 2011 to 42.9％ in 2016. The resistance rate of MRSA and MRCNS strains were significantly higher than methicillin sensitive strains. The resistance rate of Enterococcus faecium strains was significant higher than Enterococcus faecalis. The prevalence of non-susceptible Streptococcus pneumoniae was 31.2％(908). No gram-positive strain was resistant to vancomycin or linezolid. The prevalence of carbapenem resistance increased in gram-negative strains. The resistance rate of Klebsiella pneumoniae to imipenem and meropenem rose from 3.1％ and 4.8 ％ in 2011 to 28.7％ and 37.4％ in 2016, respectively.The rate of Pseudomonas aeruginosa resistance to imipenem and meropenem rose from 13.8％ and 16.5％ in 2011 to 18.8％ and 19.4％ in 2016, respectively, while Acinetobacter baumannii showed resistance rate of 38.3％ and 39.9 ％ in 2011 to 68.4％ and 69.7％ in 2016. Conclusions Increasing prevalence of MRSA, carbapenem-resistant K. pneumoniae, extensively drug-resistant A.baumannii has become a concern in clinical practice. Therefore, antimicrobial resistance surveillance should be highly strengthened in children's hospital.

OBJECTIVE:To analyze the rationality of proton pump inhibitors (PPIs) in the prevention of stress ulcer in perioperative orthopedic patients of our hospitals,and to provide reference for ratioual use of PPIs in clinic.METHODS:The medical records of discharged orthopedic patients were selected during Jan.1st-30th in 2016.Those records were analyzed statistically in respects of the use of PPIs,general information of patients,operation situation,the stressors and risk factors of stress ulcer.The rationality of the use of PPIs was analyzed comprehensively.RESULTS:Among 664 surgical patients,PPIs were used in 210 cases,and H2 receptor antagonist (H2RA) were used in 74 cases,with prophylactic rate of 42.77％.The main types of operation were fracture fixation (74 cases,35.24％),discectomy and discectomy (38 cases,18.11％).Among 210 patients receiving PPIs,all of them used PPIs,among which 68 cases (32.38％) had no medication indications,128 cases (60.95％) were medication timing error,74 cases (35.24％) were administration frequency error and 44 cases (20.95％) were more than 3 d prophylactic drug use.CONCLUSION:When orthopedic patients use PPIs for the prevention of stress ulcer,there are serious irrational phenomena in indications,species selection,usage and dosage,treatment course and so on.Clinicians and regulators should pay great attention to it so as to avoid the excessive application of PPIs.