The Risk Factors for Carbapenem-Resistant Gram-Negative Bacteria in Neonates with Ventilator-Associated Pneumonia

Dong Xuyan; Wang Yiqian; Ding Yueyin; Cheng Hongbin; Li Zhi; Liu Li; Wang Dingcheng

doi:10.13407/j.cnki.jpp.1672-108X.2023.03.010

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The Risk Factors for Carbapenem-Resistant Gram-Negative Bacteria in Neonates with Ventilator-Associated Pneumonia

更新时间：2023-04-14

- The Risk Factors for Carbapenem-Resistant Gram-Negative Bacteria in Neonates with Ventilator-Associated Pneumonia
- Vol. 29, Issue 3, Pages: 35-38(2023)
- 作者机构：
  
  1. 黄石市妇幼保健院,湖北理工学院附属妇幼保健院,湖北,黄石,435000
  2. 鄂东医疗集团黄石市中心医院,湖北,黄石,435000
- 作者简介：
- 基金信息：
- DOI：10.13407/j.cnki.jpp.1672-108X.2023.03.010
  CLC：
- Published：2023，
  
  Published Online：10 March 2023，
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Dong Xuyan, Wang Yiqian, Ding Yueyin, et al. The Risk Factors for Carbapenem-Resistant Gram-Negative Bacteria in Neonates with Ventilator-Associated Pneumonia. [J]. 29(3):35-38(2023)
DOI：

Dong Xuyan, Wang Yiqian, Ding Yueyin, et al. The Risk Factors for Carbapenem-Resistant Gram-Negative Bacteria in Neonates with Ventilator-Associated Pneumonia. [J]. 29(3):35-38(2023) DOI： 10.13407/j.cnki.jpp.1672-108X.2023.03.010.

摘要

目的:分析新生儿感染耐碳青霉烯类革兰阴性菌(CRGNB)呼吸机相关性肺炎(VAP) 的病原菌分布及危险因素。方法: 选取2018-2020 年黄石市妇幼保健院、黄石市中心医院收治的新生儿VAP 感染CRGNB 患儿75 例(CRGNB 组)

另随机选取同期同病房收治的新生儿VAP 感染碳青霉烯类敏感革兰阴性菌(CSGNB)患儿150 例为CSGNB 组

采用回顾性病例对照研究分析CRGNB 感染的危险因素。结果:CRGNB 菌株以肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌和铜绿假单胞菌等为主。CRGNB 组鲍曼不动杆菌构成比大于CSGNB 组

肺炎克雷伯菌构成比小于CSGNB 组( P 均<0. 05)。单因素分析显示

CRGNB 组与 CSGNB 组在新生儿出生体质量<1 500 g、1 min Apgar 评分<7 分、机械通气时间>14 d、累积抗菌药物用药≥3 种、抗菌药物用药时间>14 d 和孕产妇产前3 个月住院史、产前3 个月广谱抗菌药物用药史比较差异有统计学意义(P 均<0. 05)。多因素logistic 回归分析显示

新生儿出生体质量<1 500 g( OR = 2. 04)、机械通气时间>14 d( OR = 2. 37)、抗菌药物联合用药≥3 种( OR = 2. 11)、抗菌药物用药时间>14 d(OR=2. 60)和孕妇产前3 个月广谱抗菌药物用药史(OR=1. 92)为新生儿VAP 感染CRGNB 的独立危险因素。结论:新生儿VAP 感染GRGNB 与出生体质量、机械通气时间、联用抗菌药物种类、抗菌药物用药时间及孕妇产前3 个月广谱抗菌药物用药史相关

临床应针对新生儿VAP 感染CRGNB 的危险因素及时进行干预。

Abstract

Objective: To analyze the pathogen distribution and risk factors for carbapenem-resistant gram-negative bacteria (CRGNB) in neonates with ventilator-associated pneumonia (VAP). Methods: A total of 75 neonates with VAP caused by CRGNB infection in Huangshi Maternal and Child Health Hospital and Huangshi Central Hospital from 2018 to 2020 were chosen as CRGNB group

and 150 neonates with VAP caused by carbapenem-sensitive gram-negative bacteria (CSGNB) admitted to the same ward at the same time were randomly selected according to the ratio of 1 ∶ 2 as CSGNB group. Retrospective case-control study was conducted to analyze the risk factors for CRGNB infection. Results: CRGNB strains were mainly Klebsiella pneumoniae

Escherichia coli

Acinetobacter baumannii and Pseudomonas aeruginosa in neonates with VAP. The composition ratio of Acinetobacter baumannii in CRGNB group was higher than that in CSGNB group

and that of Klebsiella pneumoniae was lower than that in CSGNB group (all P< 0. 05). Single factor analysis showed that there were statistically significant differences in low birth body mass (< 1

500 g)

1 min Apgar score ( < 7 points)

breathing machine ventilation time ( > 14 d)

types of used antimicrobial agents ( ⩾ 3 kinds)

antimicrobial drug use time (>14 d) and prenatal hospitalization history and prenatal use history of broad-spectrum antibiotics before 3 months between CRGNB and CSGNB group (all P < 0. 05). Multivariate logistic regression analysis showed that newborn body weight <1

500 g (OR=2. 04)

ventilator ventilation time >14 d (OR=2. 37)

types of used antimicrobial agents ⩾3 kinds (OR= 2. 11)

antibiotics medication time >14 d (OR = 2. 60) and prenatal 3 months of broad-spectrum antibiotics (OR = 1. 92) were independent risk factors for neonatal VAP infection with CRGNB. Conclusion: The incidence of GRGNB in neonates with VAP is associated with birth weight

ventilation time

kinds of combined antibiotics

time of antibiotics administration and the prenatal medication history of 3 months of broad-spectrum antibiotics. The clinical should timely take comprehensive prevention and control measures according to the risk factors of neonatal VAP infected by CRGNB.

关键词

新生儿呼吸机相关性肺炎耐碳青霉烯类革兰阴性菌危险因素

Keywords

neonateentilator-associated pneumoniacarbapenem-resistant gram-negative bacteriarisk factor

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