Objective:To analyze the epidemiology, and infant outcomes of congenital diaphragmatic hernia (CDH) in Beijing.Methods:This retrospective study involved cases diagnosed with CDH among 877 230 fetuses/infants monitored by the Beijing Birth Defects Monitoring System from January 2018 to December 2022. Data on the occurrence of CDH, prenatal diagnosis, and infant mortality were analyzed. The statistical method was the Chi-square test (or Fisher's exact test). Results:(1) A total of 254 CDH cases were included in this study. During the study period, the incidence of CDH throughout the pregnancy and the perinatal period was 0.29 per thousand (254/877 230) and 0.17 per thousand (153/877 230), respectively. (2) Among the 254 cases, 79 (31.1%) underwent prenatal genetic diagnosis, 6.3%(5/79) copy number varations were detected, including one case of like pathogenic and four cases with types of variation unreported. The proportions of prenatal genetic diagnosis from 2018 to 2022 showed no statistically significant difference ( χ2trend=2.86, P=0.091). The gestational age at prenatal diagnosis for 241 cases was (23.0±6.4) weeks, ranging from 13 to 38 weeks; 130 cases (53.9%) were diagnosed before 25 weeks of gestation. The proportion of genetic diagnosis was higher in the group diagnosed by ultrasound before 25 weeks (43.1%, 56/130) compared to the group diagnosed at or after 25 weeks (20.7%, 23/111) ( χ2=12.59, P<0.001). (3) A total of 146 live births were recorded, with the proportion of continuing pregnancy to live birth after prenatal diagnosis being 55.2% (133/241), with no significant difference across the years. The proportion of continuing pregnancy to live birth after prenatal diagnosis in the isolated CDH group was 64.5% (100/155), higher than the 38.3% (33/86) in the non-isolated group ( χ2=15.57, P<0.001). The live birth rate for those diagnosed prenatally at<25 weeks of gestation (26.2%, 34/130) was lower than for those diagnosed at≥25 weeks of gestation (89.2%, 99/111) ( χ2=93.67, P<0.001). (4) Among the 146 live-born infants, 28 (19.2%) died during infancy. All 28 cases were prenatally diagnosed with CDH. The mortality rate of CDH infants born in tertiary obstetric institutions (17.9%, 24/134) showed a trend towards being lower than that in secondary institutions (4/12), but the difference was not statistically significant (Fisher's exact test, P=0.245). Among the 118 surviving infants, seven were abandoned from treatment, and of the remaining 111, 104 (93.7%) were treated at the Children's Hospital, Capital Institute of Pediatrics. The infant mortality rate at this institution (15.4%, 16/104) showed a trend towards being lower than that at other institutions (3/7), but the difference was not statistically significant (Fisher's exact test, P=0.096). The infant mortality rate for those diagnosed prenatally at<25 weeks of gestation (38.2%, 13/34) was higher than for those diagnosed at≥25 weeks of gestation (15.2%, 15/99) ( χ2=6.78, P=0.009). Conclusions:Beijing achieved good secondary and tertiary prevention outcomes in prenatal diagnosis and reducing infant mortality. The concentration of neonatal surgical resources is beneficial for accumulating surgical experience and reducing infant mortality.

Objective:To analyze the epidemiology, and infant outcomes of congenital diaphragmatic hernia (CDH) in Beijing.Methods:This retrospective study involved cases diagnosed with CDH among 877 230 fetuses/infants monitored by the Beijing Birth Defects Monitoring System from January 2018 to December 2022. Data on the occurrence of CDH, prenatal diagnosis, and infant mortality were analyzed. The statistical method was the Chi-square test (or Fisher's exact test). Results:(1) A total of 254 CDH cases were included in this study. During the study period, the incidence of CDH throughout the pregnancy and the perinatal period was 0.29 per thousand (254/877 230) and 0.17 per thousand (153/877 230), respectively. (2) Among the 254 cases, 79 (31.1%) underwent prenatal genetic diagnosis, 6.3%(5/79) copy number varations were detected, including one case of like pathogenic and four cases with types of variation unreported. The proportions of prenatal genetic diagnosis from 2018 to 2022 showed no statistically significant difference ( χ2trend=2.86, P=0.091). The gestational age at prenatal diagnosis for 241 cases was (23.0±6.4) weeks, ranging from 13 to 38 weeks; 130 cases (53.9%) were diagnosed before 25 weeks of gestation. The proportion of genetic diagnosis was higher in the group diagnosed by ultrasound before 25 weeks (43.1%, 56/130) compared to the group diagnosed at or after 25 weeks (20.7%, 23/111) ( χ2=12.59, P<0.001). (3) A total of 146 live births were recorded, with the proportion of continuing pregnancy to live birth after prenatal diagnosis being 55.2% (133/241), with no significant difference across the years. The proportion of continuing pregnancy to live birth after prenatal diagnosis in the isolated CDH group was 64.5% (100/155), higher than the 38.3% (33/86) in the non-isolated group ( χ2=15.57, P<0.001). The live birth rate for those diagnosed prenatally at<25 weeks of gestation (26.2%, 34/130) was lower than for those diagnosed at≥25 weeks of gestation (89.2%, 99/111) ( χ2=93.67, P<0.001). (4) Among the 146 live-born infants, 28 (19.2%) died during infancy. All 28 cases were prenatally diagnosed with CDH. The mortality rate of CDH infants born in tertiary obstetric institutions (17.9%, 24/134) showed a trend towards being lower than that in secondary institutions (4/12), but the difference was not statistically significant (Fisher's exact test, P=0.245). Among the 118 surviving infants, seven were abandoned from treatment, and of the remaining 111, 104 (93.7%) were treated at the Children's Hospital, Capital Institute of Pediatrics. The infant mortality rate at this institution (15.4%, 16/104) showed a trend towards being lower than that at other institutions (3/7), but the difference was not statistically significant (Fisher's exact test, P=0.096). The infant mortality rate for those diagnosed prenatally at<25 weeks of gestation (38.2%, 13/34) was higher than for those diagnosed at≥25 weeks of gestation (15.2%, 15/99) ( χ2=6.78, P=0.009). Conclusions:Beijing achieved good secondary and tertiary prevention outcomes in prenatal diagnosis and reducing infant mortality. The concentration of neonatal surgical resources is beneficial for accumulating surgical experience and reducing infant mortality.

OBJECTIVE：To pro vide reference for rational use of antibiotics in pediatric department. METHODS ：Clinical bacterial strains isolated from children outpatients and inpatients were collected from West China Guang ’an Hospital of Sichuan University（called“our hospital ”for short ）during Jan. 2014 to Jun. 2019. Distribution and drug resistance of bacteria were analyzed retrospectively. RESULTS ：During 2014-2019，total of 4 692 strains were detected ，accounting for 29.56％ of total ；those were mainly from sputum （3 749 strains，79.90％），blood（203 strains，4.33％）and secretion （137 strains，2.92％）specimen. Among them ，1 488 strains of Gram-positive bacteria （31.71％）were mainly Streptococcus pneumoniae （711 strains，15.15％） and Staphylococcus aureus （574 strains，12.23％）；3 204 strains of Gram-negative bacteria （68.29％）were mainly 2 466 strains of Haemophilus influenza （52.56％）. Totally 172 strains of methicillin-resistant S. aureus and 1 517 strains of β-lactamase producing H. influenzae were detected ；the detection rates were 29.97％ and 61.52％ ，respectively. Resistance rates of H. influenza to ampicillin，cefaclor and cefuroxime were higher than 50％，and the overall trend was on the rise ，resistance rates of cefotaxime ， rifampin and ofloxacin were all lower than 6％. Resistance rates of S. pneumoniae to erythromycin and tetracycline were more than 70％，and the resistance rate to erythromycin was increasing year by year. Resistance rates of S. pneumoniae to β-lactams and quinolones were generally lower than 20％. No resistant strains of linezolid and vancomycin were found. Resistance rate of S. aureus to penicillin G was more than 90％. S. aureus was relarively sensitive to aminoglycosides ，macrolides and tetracyclines ；no furantoin，linezolid and vancomycin-resistant strains were found. CONCLUSIONS ：Gram-negative bacteria are the main pathogens isolated from children in our hospital ，and most of them are H. influenza e，S. pneumon iae and other caustic bacteria. The detection rate of drug-resistant and enzyme producing strains is high ， and the resistance rate of several pathogens to commonly used 0826-2600251。E-mail：wenxiaozheng269@sina.com antibiotics is increasing year by year. Drug resistance is severe. In order to delay the emergence and spread of drug-resistant pathogens in real time and further standardize the use of pediatric antibiotics.

Objective: To retrospectively analyze the distribution of non-fermentative bacteria causing bloodstream infection in hospitalized patients in Sichuan Province and their drug susceptibility to common antibiotics for better understanding their epidemiological characteristics. Methods: From January 1, 2015 to December 31, 2017, all of the non-fermentative bacteria isolated from patients with bloodstream infection in nine hospitals in Sichuan Province were collected. Species distribution and drug resistance test results were retrospectively analyzed. Results: A total of 6 291 strains of pathogenic bacteria were isolated, including 3 674 strains of gram-negative bacteria (58.4%) and 2 617 strains of gram-positive bacteria (41.6%). The gram-positive bacteria were 1 895 strains of Staphylococcus (30.1%), 372 strains of Streptococcus (5.9%), 317 strains of Enterococcus (5.1%) and 33 strains of other gram-positive bacteria (0.5%). The gram-negative bacteria were 3 191 Enterobacteriaceae strains (50.7%), 389 non-fermentative strains (6.2%) and 94 other gram-negative strains (1.5%). The isolated non-fermentative bacteria were mainly Pseudomonas aeruginosa (136 strains, 35.0%), Acinetobacter baumannii (126 strains, 32.0%) and Stenotrophomonas maltophilia (33 strains, 8.5%). There were 167 (42.9%), 112 (28.8%) and 82 (21.1%) non-fermentative bacteria isolated in internal medicine departments, ICUs and surgery departments, respectively. The drug resistance rates of Pseudomonas aeruginosa to cefepime, ciprofloxacin and gentamicin were 16.5%, 10.7% and 9.9%, respectively. Carbapenems-resistant Pseudomonas aeruginosa (CR-PA) accounted for 13.6%. No polymyxin-resistant Pseudomonas aeruginosa was found. The resistance rates of Acinetobacter baumannii to all antibiotics were over 30% except for minocycline and polymyxin and 75.7% of carbapenem-resistant Acinetobacter baumannii (CR-AB) were isolated. The drug resistance rates to levofloxacin, trimethoprim/sulfamethoxazole and ceftazidime were 0%, 0% and 37.0% in Stenotrophomonas maltophilia isolates and 10.5%, 4.2% and 19% in Burkholderia cepacia isolates, respectively. Conclusions Non-fermentative bacteria causing 6.2% of bloodstream infection in Sichuan, mainly by Pseudomonas aeruginosa and Acinetobacter baumannii. There were significant differences in the isolation rate of non-fermentative bacteria in different departments and most of the strains were isolated in internal medicine departments. The detection rate of Acinetobacter baumannii with multiple drug resistance was high, while other non-fermentative bacteria had good sensitivity to antibiotics.