| 摘要: |
| 目的:探讨儿童多重耐药肺炎克雷伯菌(MR-KPN)感染的独立危险因素,为其治疗及防控提供循证依据。方法:回顾性
分析暨南大学附属东莞医院2017-2020 年收治的124 例肺炎克雷伯菌(KPN) 感染患儿临床资料,根据是否发生多重耐药分为
MR-KPN 组43 例和KPN 组81 例。通过单因素分析筛选MR-KPN 感染的危险因素,二元Logistic 回归分析独立危险因素。结
果:两组标本来源均以痰液为主。患儿年龄、住院时间、预后、早产、低出生体质量、双胎、既往病史( 肺炎、泌尿道感染、其他疾
病)、培养前使用抗菌药物(β-内酰胺类复合制剂、第二代头孢菌素、第三代头孢菌素、碳青霉烯类)、院内感染、静脉用糖皮质激
素、肠外营养液、免疫抑制剂、住院使用抗菌药物(碳青霉烯类、β-内酰胺类复合制剂、其他抗菌药物)、侵入性操作(胃管、导尿
管、鼻饲管及其他操作)、抗菌药物使用时间和首次培养阳性前C 反应蛋白( CRP) 水平为MR-KPN 感染发生的危险因素( P<
0. 05);早产、培养前使用β-内酰胺类复合制剂和鼻饲置管为MR-KPN 感染的独立危险因素(P<0. 05)。结论:早产、培养前使
用β-内酰胺类复合制剂和鼻饲置管是儿童发生MR-KPN 感染的独立危险因素。 |
| 关键词: 儿童 多重耐药肺炎克雷伯菌 危险因素 Logistic 回归分析 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2023.02.005 |
|
| 基金项目:广东省基础与应用基础研究基金项目,编号2019A1515110369;东莞市社会科技发展(重点)项目,编号201950715025174。 |
|
| Related Risk Factors Analysis of Multidrug-Resistant Klebsiella Pneumoniae Infection in Children |
| Yang Liling1, Zhou Xiangjun2, Zheng Wujuan1, Deng Yanxian1, Li Wei1 |
| ((1. Dongguan Affiliated Hospital of Jinan
University, Guangdong Dongguan 523808, China; 2. Guangdong Medical University, Guangdong Dongguan 523808, China)) |
| Abstract: |
| Objective: To analyze the independent risk factors of multidrug-resistant Klebsiella pneumoniae (MR-KPN) infection in
children, so as to provide scientific basis for preventing and controlling MR-KPN infection. Methods: The clinical data of 124 child
patients infected with Klebsiella pneumoniae(KPN) treat in Dongguan Affiliated Hospital of Jinan University from 2017 to 2020 were
retrospectively analyzed, and they were divided into two groups, MR-KPN group (n = 43) and KPN group (n = 81), based on the
occurrence of multidrug resistance. The differences between two groups were analyzed by single-factor analysis and the independent risk
factors of MR-KPN infection were analyzed by logistic regression analysis. Results: The samples of the two groups were mainly sputum.
The single-factor analysis showed that the following aspects were the risk factors for MR-KPN infection in children: age, length of stay, prognosis, premature birth, low birth weight, twins, past medical histories (pneumonia, urinary tract infection or other diseases), use
of antibiotics before culture ( β-lactam antibiotic compound preparation, second-generation cephalosporins, third-generation
cephalosporins, carbapenems), hospital-acquired infections, intravenous glucocorticoids, parenteral nutrition, immunosuppressants, use
of antibiotics in hospital (carbapenems, β-lactam antibiotic compound preparation or other antibacterial drugs), invasive operations
(gastric tube, urinary catheter, nasal feeding tube and other operations), the time of using antibiotics and the level of C-reactive protein
(CRP) before the first positive culture (P<0. 05). Logistic regression analysis showed that premature birth, using β-lactam antibiotic
compound preparation before the culture, and nasogastric feeding tube were the independent risk factors for MR-KPN infection (P <
0. 05). Conclusion: Premature birth, using β-lactam antibiotic compound preparation before the culture, and nasogastric feeding tube
are the independent risk factors of MR-KPN infection in children. |
| Key words: children multidrug-resistant Klebsiella pneumoniae risk factor Logistic regression analysis |
