Abstract: Objective To analyze the clinical characteristics of Burkholderia cepacia （BC） infections in pediatric patients and evaluate the drug susceptibility of isolated strains， thereby providing a reference for clinical diagnosis and treatment. Methods Clinical data and drug susceptibility profiles were collected from 58 pediatric patients hospitalized with Burkholderia cepacia infections at the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University between January 1， 2019， and December 31， 2023. A retrospective analysis was performed，encompassing patients’ demographic information， high-risk factors， sample sources， departmental distribution，laboratory test results， antibiotic susceptibility patterns， and clinical outcomes. Results Among the 58 patients， there were 34 males and 24 females， with ages ranging from 49 days to 17 years and a median age of 9 months （4.0-54.3）. The age distribution was as follows：≤1 year： 31 cases （53.4%）; >1-3 years： 8 cases （13.8%）; >3-5 years： 6 cases （10.3%）; >5-10 years： 6 cases （10.3%）; >10 years： 7 cases （12.1%）. The department with the highest incidence was the pediatric intensive care unit （86.2%， 50/58）， followed by pediatric nephrology （10.3%， 6/58）. The sample sources comprised sputum （n=50）， urine （n=6）， blood （n=5）， abdominal effusion （n=3）， catheter tips （n=1）， and cerebrospinal fluid （n=1）， totaling 66 strains. Burkholderia cepacia was detected across multiple sites in 6 patients. The clinical diagnoses encompassed lung infection 
（n=50）， urinary tract infection （n=6）， sepsis （n=5），peritonitis （n=3）， among others. Notably， 49 cases （84.5%） were identified as hospital-acquired infections，while 9 cases （15.5%） were classified as community-acquired infections. Among the 58 BC strains analyzed， the resistance rate of Burkholderia cepacia to ceftazidime was 3.4% （2/58）， while levofloxacin exhibited no resistance， though an intermediate susceptibility rate of 6.9% （4/58） was observed. The resistance rate to sulfamethoxazole/trimethoprim was 5.2% （3/58）. Clinical outcomes of the cases were as follows： 35 patients were cured， 12 showed improvement， 9 discontinued treatment， and 2 died. Conclusion Pediatric BC infections are primarily nosocomial infections， frequently occurring in intensive care units （ICUs）， with pulmonary infections representing the most prevalent clinical manifestation， demonstrating a high susceptibility to ceftazidime，sulfamethoxazole/trimethoprim， and levofloxacin.

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摘要： 目的 分析儿童洋葱伯克霍尔德菌感染的临床特征以及分离菌株的药物敏感情况，为临床诊疗提供参考依据。方法　收集2019年1月1日至2023年12月31日于温州医科大学附属第二医院育英儿童医院住院的58例洋葱伯克霍尔德菌感染患儿的临床资料及分离菌株的药物敏感性。回顾性分析患儿的一般情况、高危因素、标本来源、分布科室、实验室检查、药敏情况和预后。结果 58例患儿中男34例、女24例，年龄49d 至17岁，中位年龄为9（4.0~54.3）月龄。其中≤ 1岁31例（53.4%）、>1~3岁8例（13.8%）、>3~5岁6例（10.3%）、>5~10岁6例（10.3%）、>10岁7例（12.1%）。检出科室最主要为重症监护室（86.2%，50/58）、其次为肾内科（10.3％，6/58）。标本来源分别为痰（50例）、尿（6例）、血（5例）、腹腔积液（3例）、导管尖端（1例）、脑脊液（1例），共66株，其中6例患儿在多部位检出洋葱伯克霍尔德菌。临床诊断依次为肺部感染（50例）、尿路感染（6例）、败血症（5例）、腹膜炎（3例）等。医院获得性感染49例（84.5%），社区获得性感染9例（15.5%）。58例洋葱伯克霍尔德菌菌株对头孢他啶耐药率为3.4%（2/58），对左氧氟沙星耐药率为0，中介率6.9%（4/58），对磺胺甲恶唑 / 甲氧苄啶耐药率为5.2%（3/58）。治愈35例，好转12例，放弃9例，死亡2例。结论 儿童洋葱伯克霍尔德菌以院内感染为主，多见于重症监护室，临床以肺部感染最为多见，对头孢他啶、磺胺甲恶唑 / 甲氧苄啶、左氧氟沙星的药物敏感性普遍较高。

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