Objective: To analyze the drug resistance of multidrug-resistant organism (MDRO) among hospitalized children in a children's hospital in Hebei Province from 2019 to 2023, so as to provide the basis for the rational clinical application of antibacterial drugs. Methods: Specimens including sputum, blood, urine, pus, bronchoalveolar lavage fluid, secretions, pleural fluid, and peritoneal fluid of hospitalized children from January 2019 to December 2023 were collected. Pathogen identification and drug susceptibility tests were performed on methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum β-lactamase-producing Escherichia coli (ESBLs-EC), extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBLs-KP), carbapenem-resistant Klebsiella pneumoniae (CRKP), carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Pseudomonas aeruginosa (CRPA) and carbapenem-resistant Escherichia coli (CREC). The department distribution, specimen distribution, and drug resistance of MDROs were analyzed. Results: A total of 279 086 samples were submitted for testing, with 3 512 MDROs detected. Among these, MRSA and ESBLs-EC had relatively high detection rates of 35.76% and 41.50%, respectively. In the internal medicine pediatric patients, 1 869 MDROs were detected, accounting for 53.22%. The main departments were respiratory medicine, neonatology, and intensive care. In the surgical department, 1 643 MDROs were detected, accounting for 46.78%, with the main sources being general surgery and cardiac surgery. The highest numbers of MDROs were detected in sputum, pus, and urine samples, with 1 372, 527, and 494 isolates, representing 39.07%, 15.01%, and 14.07%, respectively. The resistance rates of MRSA to penicillin, oxacillin, and erythromycin were between 81.76% and 100.00%. ESBLs-EC and ESBLs-KP had a resistance rate of 100.00% to ceftriaxone. CRKP had a resistance rate of 100.00% to ampicillin/sulbactam and imipenem. CRAB had a resistance rate of 100.00% to cefoxitin, imipenem, and meropenem. CRPA had a resistance rate of 100.00% to ampicillin/sulbactam, ceftriaxone, cefoxitin, and imipenem. CREC had a resistance rate of 100.00% to imipenem. Conclusions In a children's hospital in Hebei Province, infections with MDROs among hospitalized pediatric patients are primarily caused by MRSA and ESBLs-EC. These infections are mainly distributed in the departments of respiratory medicine, neonatology, intensive care, general surgery, and cardiac surgery, with the highest detection rates in sputum, pus, and urine samples. Additionally, MRSA, ESBLs-EC, ESBLs-KP, CRKP, CRAB, CRPA, and CREC show high resistance rate to most antimicrobial agents.

Objective:To explore the effect of systematic pain management on pain of children with traumatic limb fractures.Methods:A total of 185 children with traumatic limb fracture who were treated in Children's Hospital of Hebei Province from January 2019 to December 2020 were selected as the research objects by the convenient sampling method. According to the random number table method, they were randomly divided into the intervention group (93 cases) and the control group (92 cases) . Children in both groups were treated with fracture surgery under general anesthesia. The intervention group used systematic pain management for intervention, and the control group used conventional pain management for intervention. The operation time, wake up time, extubation time, Ramsay sedation score after wake-up and Modified Objective Pain Score (MOPS) at admission, 24, 48 h after admission, and 24, 48 h after surgery were compared between the two groups.Results:There was no statistically significant difference in operation time, wake-up time, extubation time and Ramsay sedation scores after wake-up between the two groups ( P>0.05) . On admission, there was no statistically significant difference in the MOPS scores of children between the two groups ( P>0.05) . At 24 and 48 hours after admission and 24 and 48 hours after operation, MOPS scores of the intervention group were lower than those of the control group, and the differences were statistically significant ( P<0.01) . Conclusions:Compared with conventional pain management, systemic pain management can alleviate the pain of traumatic limb fractures in children.

Objective To study the pathogens and their drug susceptibility of septic arthritis of hip in children. Methods Prior to the antibiotic treatment, pus was extracted for bacterial culture under aseptic operation. The pathogenic bacterium was identified and drug susceptibility was analyzed using a fully automated bacterial identification/drug susceptibility system. Results A total of 68 pathogens were isolated, in which 42 were Gram-positive bacteria, 23 were Gram-negative bacteria and 3 were fungi. The results showed differences in the bacterial types of hip septic arthritis in children with different ages (5 days to 13 years). For newborns (less than 1 month), the most common pathogen was Klebsiella pneumoniae; for the ages of 1 month to 13 years old, the most common pathogen was Staphylococcus aureus. The results of drug susceptibility tests showed that Gram-positive bacteria were highly susceptible to vancomycin, teicoplanin and linezolid;the resistance of Staphylococcus aureus to penicillin was up to 96％; and Klebsiella pneumoniae, Escherichia coli, Haemophilus influenzae, Enterobacter cloacae and Salmonella were highly sensitive to meropenem and imipenem. Conclusion In the antimicrobial drug treatment of children with hip septic arthritis, the etiology sample should be collected for drug susceptibility analysis. Empirical drug therapy strategy should be applied in the absence of the analysis results. Sensitive antibiotic drug therapy should be used after obtaining reliable etiological diagnosis and drug susceptibility results, and simultaneously taking the age into consideration.