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Citation: Shuangshuang WANG, Yaling LI, Liqin CHEN, Yonghui HAN, Mingbiao MA, Xiaojuan LI. The Analysis of Risk Factors and Drug Resistance of CRE Infection in Children’s Intensive Care Unit[J]. Journal of Kunming Medical University, 2023, 44(9): 49-54. doi: 10.12259/j.issn.2095-610X.S20230918

The Analysis of Risk Factors and Drug Resistance of CRE Infection in Children’s Intensive Care Unit

doi: 10.12259/j.issn.2095-610X.S20230918
  • Received Date: 2023-06-01
    Available Online: 2023-09-14
  • Publish Date: 2023-09-30
  •   Objective  To study the drug resistance of CRE infection in children in the intensive care unit and the risk factors of nosocomial infection of CRE, and to provide the reference for the treatment of CRE infection in children and the formulation of infection prevention and control strategies in hospitals.  Methods  Clinical data of children admitted to the intensive care unit of a 3A Children’s Hospital in Yunnan Province from January 2019 to December 2022 were retrospectively analyzed. 92 cases with nocometary infection of carbapenem-resistant enterobacteriaceae bacteria (CRE) were included in the case group, and 92 cases with carbapenem-sensitive enterobacteriaceae (CSE) infection were randomly selected at 1∶1. According to the group, strain identification and drug sensitivity test were carried out to analyze the infection strains and drug resistance. Univariate and multivariate logistic regression analysis was conducted for children with CRE infection by SPSS 26.0, to explore the risk factors related to CRE infection in severely ill children.  Results  Klebsiellapneumoniae was detected in 81 cases (88.04%), followed by Escherichiacoli in 5 cases (5.43%). The drug resistance rates of levofloxacin, amoxicillin/clavulanic acid, ceftazidime, imipenem, cefepime, ceftriaxoneand amikacin in CRE group were higher than those in CSE group, and the differences were statistically significant (P < 0.05).Univariate analysis showed that indwelling gastric tube, central venous catheterization, mechanical ventilation, history of using carbapenems, glycopeptides and polymyxin antibiotics, types of antibiotics used ≥3, time of using antibiotics, time of using carbapenems, time of staying in ICU and total hospital stay were all risk factors of CRE infection, showing statistically significant differences (P < 0.05).Multivariate logistic regression analysis showed that carbapenem antibiotic use history and use time and antibacterial use time (P < 0.05) were independent risk factors for CRE infection in severely ill children.  Conclusion  Combined with the risk factors of severe children’s CRE infection, we should minimize invasive operations such as puncture and intubation, standardize the use and management of antibiotics in the treatment of severe children, especially carbapenem antibiotics, shorten the length of stay in ICU and the total length of stay as much as possible, strengthen the active screening of severe children’s CRE, formulate reasonable and effective infection prevention and control strategies, and reduce the occurrence of nosocomial infection of severe children’s CRE.
  • [1]
    张琴,许健,宋培培. 儿童患者检出耐碳青霉烯类抗菌药物肠杆菌科细菌分布特征及耐药性分析[J]. 中国抗生素杂志,2020,45(12):1273-1278. doi: 10.3969/j.issn.1001-8689.2020.12.012
    [2]
    Willyard C. The drug-resistant bacteria that pose the greatest health threats[J]. Nature,2017,543(7643):15. doi: 10.1038/nature.2017.21550
    [3]
    周冉,方玉婷,苏丹,等. 儿童耐碳青霉烯类肠杆菌目细菌感染治疗药物研究进展[J]. 中国感染控制杂志,2022,21(2):204-208.
    [4]
    Logan L K. Carbapenem-resistant enterobacteriaceae: An emerging problem in children[J]. Clin Infect Dis,2012,55(6):852-859. doi: 10.1093/cid/cis543
    [5]
    员静,单斌,孟雪斐,等. 2018—2020年多中心耐碳青霉烯类肠杆菌目细菌的流行病学特征及耐药性分析[J]. 中国抗生素杂志,2021,46(11):1038-1043. doi: 10.3969/j.issn.1001-8689.2021.11.009
    [6]
    中华人民共和国卫生部. 医院感染诊断标准(试行)[J]. 中华医学杂志,2001,81(5):314-320. doi: 10.3760/j:issn:0376-2491.2001.05.027
    [7]
    Bartsch S M,McKinnell J A,Mueller L E,et al. Potential economic burden of carbapenem-resistant enterobacteriaceae(CRE) in the United States[J]. Clin Microbiol Infect,2017,23(1):48.e9-48.e16. doi: 10.1016/j.cmi.2016.09.003
    [8]
    于佳,张静,李莉珊,等. ICU患者耐碳青霉烯类肠杆菌科细菌感染特征及危险因素[J]. 中华医院感染学杂志,2022,32(21):3215-3219.
    [9]
    刘思娣,吴安华,李春辉,等. 高危科室住院患者肠道耐碳青霉烯类肠杆菌科细菌筛查及其阳性危险因素[J]. 中华医院感染学杂志,2023,33(4):517-521.
    [10]
    房锐颖,张亚萍,陶云珍,等. 苏州大学附属儿童医院碳青霉烯类耐药肠杆菌目细菌流行特征及耐药基因分析[J]. 安徽医学,2022,43(3):271-275. doi: 10.3969/j.issn.1000-0399.2022.03.005
    [11]
    付盼,王传清,俞蕙,等. 中国儿童细菌耐药监测组2018年儿童细菌感染及耐药监测[J]. 中国循证儿科杂志,2019,14(5):321-326.
    [12]
    张甜甜,刘志武,徐腾飞,等. 某三甲医院耐碳青霉烯类肠杆菌科细菌耐药性和耐消毒剂基因分析[J]. 中华医院感染学杂志,2023,33(3):325-329.
    [13]
    中国碳青霉烯耐药肠杆菌科细菌感染诊治与防控专家共识编写组,中国医药教育协会感染疾病专业委员会,中华医学会细菌感染与耐药防控专业委员会. 中国碳青霉烯耐药肠杆菌科细菌感染诊治与防控专家共识[J]. 中华医学杂志,2021,101(36):2850-2860.
    [14]
    黄兰清,陈清秀,蔡榕,等. 儿童重症监护病区多重耐药菌感染情况及危险因素[J]. 中华医院感染学杂志,2020,30(9):1436-1440.
    [15]
    林碧玉,刘婧婷,金凤玲. 儿童耐碳青霉烯类肠杆菌定植或感染危险因素的Meta分析[J]. 中国当代儿科杂志,2022,24(1):96-101. doi: 10.7499/j.issn.1008-8830.2109025
    [16]
    许渝,黄砚屏,罗万军. 新生儿耐碳青霉烯类肠杆菌感染影响因素[J]. 中国感染控制杂志,2020,19(12):1098-1101. doi: 10.12138/j.issn.1671-9638.20206029
    [17]
    Al-Gethamy M M,Faidah H S,Adetunji H A,et al. Risk factors associated with multi-drug-resistant Acinetobacter baumannii nosocomial infections at a tertiary care hospital in Makkah,Saudi Arabia - a matched case-control study[J]. J Int Med Res,2017,45(3):1181-1189. doi: 10.1177/0300060517706284
    [18]
    Li X,Xu X,Yang X,et al. Risk factors for infection and/or colonisation with extended-spectrum β-lactamase-producing bacteria in the neonatal intensive care unit: A meta-analysis[J]. Int J Antimicrob Agents,2017,50(5):622-628. doi: 10.1016/j.ijantimicag.2017.06.027
    [19]
    Chiotos K,Tamma P D,Flett K B,et al. Multicenter study of the risk factors for colonization or infection with carbapenem-resistant enterobacteriaceae in children[J]. Antimicrob Agents Chemother,2017,61(12):e01440.
    [20]
    杨欣,鲁利群,黄莉,等. 儿科碳青霉烯类耐药肺炎克雷伯菌感染危险因素及其耐药性[J]. 中华医院感染学杂志,2020,30(22):3470-3473.
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