目的 评价多黏菌素B治疗儿童耐碳青霉烯类革兰阴性杆菌（CRGNB）感染的疗效和安全性。方法 回顾性分析2020年7月—2021年12月儿科重症监护病房收治确诊或高度怀疑CRGNB感染并使用多黏菌素B抗感染患儿的临床资料。结果 纳入20例CRGNB患儿，男11例、女9例，中位年龄为3.4（0.6~8.9）岁，12例治愈，1例死亡。基础疾病以血液肿瘤系统疾病最多（30.0%）。感染标本检出主要为深部痰液或肺泡灌洗液（75.0%），其次为血液（10.0%）。耐碳青霉烯肺炎克雷伯菌为最常分离的微生物（35.0%，7/20），其次为耐碳青霉烯铜绿假单胞菌（30%，6/20）；另有4例为多种CRGNB混合感染。所有患儿均采用多黏菌素B联合用药方式，以美罗培南为主（9例，45.0%），20例患儿均未观察到毒副反应。存在下呼吸道感染的15例患儿中，与单纯多黏菌素B静脉注射用药相比，增加局部雾化用药患儿的治愈率更高（P=0.002）。结论 多黏菌素B治疗儿童CRGNB感染的疗效和安全性值得肯定，但目前亟需更多、更大规模的临床研究做进一步探索和评估。

Objective To evaluate the efficacy and safety of polymyxin B in the treatment of carbapenem-resistant Gram-negative bacteria (CRGNB) infection in children. Methods From July 2020 to December 2021, 32 cases of carbapenem-resistant Gram-negative bacteria infection in PICU with using polymyxin B were retrospectively analysed. Results 20 patients enrolled in the retrospective cohort, 11 males and 9 females, with a median age of 3.4 (0.6-8.9) years; 12 were cured and 1 died. The underlying diseases were most frequently haemato-oncological system diseases (30.0%). Infection specimens from 20 patients were mainly detected in sputum or bronchoalveolar lavage fluid (75%), followed by blood (10%). Carbapenem-resistant Klebsiella pneumoniae was the most frequently isolated organism (35.0%, 7/20), followed by carbapenem-resistant Pseudomonas aeruginosa with 30% (6/20). Another 4 cases were mixed infection of multiple carbapenem-resistant Gram-negative bacilli.. All children were treated with a polymyxin B combination, with meropenem as the mainstay (9 cases, 45.0%), and no adverse reactions were observed in 20 cases. Of the 15 children with lower respiratory tract infections, a higher cure rate was observed in children with the addition of topical nebulisation compared to the intravenous administration of polymyxin B alone (P=0.002).Conclusion The efficacy and safety of polymyxin B in the treatment of severe carbapenem-resistant Gram-negative bacterial infection in children is worthy of affirmation. However, more and large-scale clinical studies are urgently needed for further exploration and evaluation..