Related Risk Factors Analysis of Multidrug-Resistant Klebsiella Pneumoniae Infection in Children

Yang Liling; Zhou Xiangjun; Zheng Wujuan; Deng Yanxian; Li Wei

doi:10.13407/j.cnki.jpp.1672-108X.2023.02.005

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Related Risk Factors Analysis of Multidrug-Resistant Klebsiella Pneumoniae Infection in Children

更新时间：2023-04-14

- Related Risk Factors Analysis of Multidrug-Resistant Klebsiella Pneumoniae Infection in Children
- Vol. 28, Issue 2, Pages: 18-23(2023)
- 作者机构：
  
  1. 暨南大学附属东莞医院,广东,东莞,523808
  2. 广东医科大学,广东,东莞,523808
- 作者简介：
- 基金信息：
- DOI：10.13407/j.cnki.jpp.1672-108X.2023.02.005
  CLC：
- Published：2023，
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Yang Liling, Zhou Xiangjun, Zheng Wujuan, et al. Related Risk Factors Analysis of Multidrug-Resistant Klebsiella Pneumoniae Infection in Children. [J]. 28(2):18-23(2023)
DOI：

Yang Liling, Zhou Xiangjun, Zheng Wujuan, et al. Related Risk Factors Analysis of Multidrug-Resistant Klebsiella Pneumoniae Infection in Children. [J]. 28(2):18-23(2023) DOI： 10.13407/j.cnki.jpp.1672-108X.2023.02.005.

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。

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.

关键词

儿童多重耐药肺炎克雷伯菌危险因素Logistic 回归分析

Keywords

childrenmultidrug-resistant Klebsiella pneumoniaerisk factorLogistic regression analysis

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