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

Shuangshuang WANG; Yaling LI; Liqin CHEN; Yonghui HAN; Mingbiao MA; Xiaojuan LI

doi:10.12259/j.issn.2095-610X.S20230918

Volume 44 Issue 9

Sep. 2023

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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

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

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

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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

Dept. of Infection Management of Kunming Children’s Hospital/Children’s Hospital Affiliated to Kunming Medical University，Kunming Yunnan 650228，China

Received Date: 2023-06-01
Available Online: 2023-09-14
Publish Date: 2023-09-30

Abstract

Abstract

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.
- Children’s intensive care unit,
- CRE,
- Risk factors,
- Drug resistance

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