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[儿童耐碳青霉烯类感染的临床特征及危险因素]

[Clinical characteristics and risk factors of carbapenem-resistant infection in children].

作者信息

Peng Yi-Lu, Wang Hong-Mei, Li Chi, Zhang Jiao-Sheng, Qi Li-Feng

机构信息

Department of Infectious Medicine, Shenzhen Children's Hospital, China Medical University, Shenzhen, Guangdong 518036, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2024 Nov 15;26(11):1169-1175. doi: 10.7499/j.issn.1008-8830.2407020.

DOI:10.7499/j.issn.1008-8830.2407020
PMID:39587745
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11601102/
Abstract

OBJECTIVES

To investigate the clinical characteristics of carbapenem-resistant (CRPA) infection in children and the risk factors for such infection.

METHODS

A retrospective analysis was conducted among 60 children with CRPA infection (CRPA group) who were hospitalized in Shenzhen Children's Hospital, China Medical University, from January 2018 to September 2023, and 82 children with carbapenem-sensitive infection during the same period were randomly selected as the control group. A multivariate logistic regression analysis was used to investigate the risk factors for CRPA infection.

RESULTS

Among the 60 children with CRPA infection, 31 (52%) were admitted to the intensive care unit (ICU), and the lower respiratory tract was the main detection site in 32 children (53%). The univariate analysis showed that sex, history of invasive treatment within 1 year, antibiotic use before admission, presence of underlying condition, ICU admission, invasive procedure after admission, antibiotic use for >14 days, and the type of antibiotics used of ≥3 were associated with CRPA infection (<0.05). The multivariate logistic regression analysis showed that the history of invasive treatment within 1 year (=3.228, <0.05), antibiotic use before admission (=4.052, <0.05), antibiotic use for >14 days (=4.961, <0.05), and the type of antibiotics used of ≥3 (=3.687, <0.05) were independent risk factors for CRPA infection in children.

CONCLUSIONS

CRPA infection in children may be associated with a history of invasive treatment within the past year, antibiotic use before admission, duration of antibiotic use after admission, and the diversity of antibiotic types used.

摘要

目的

探讨儿童耐碳青霉烯类肺炎克雷伯菌(CRPA)感染的临床特征及感染的危险因素。

方法

对2018年1月至2023年9月在中国医科大学附属深圳儿童医院住院的60例CRPA感染儿童(CRPA组)进行回顾性分析,并随机选取同期82例碳青霉烯类敏感感染儿童作为对照组。采用多因素logistic回归分析探讨CRPA感染的危险因素。

结果

60例CRPA感染儿童中,31例(52%)入住重症监护病房(ICU),32例(53%)主要检测部位为下呼吸道。单因素分析显示,性别、1年内有创治疗史、入院前使用抗生素、存在基础疾病、入住ICU、入院后有创操作、抗生素使用时间>14天以及使用抗生素种类≥3种与CRPA感染有关(P<0.05)。多因素logistic回归分析显示,1年内有创治疗史(β=3.228,P<0.05)、入院前使用抗生素(β=4.052,P<0.05)、抗生素使用时间>14天(β=4.961,P<0.05)以及使用抗生素种类≥3种(β=3.687,P<0.05)是儿童CRPA感染的独立危险因素。

结论

儿童CRPA感染可能与过去1年内的有创治疗史、入院前使用抗生素、入院后抗生素使用时间及使用抗生素种类的多样性有关。