某院下呼吸道感染患儿发生抗菌药物相关性腹泻的危险因素与预测模型分析  

Risk Factors and Predictive Model Analysis of Antibiotic-associated Diarrhea in Children with Lower Respiratory Tract Infection in a Hospital

作　　者：刘莹 潘美余 万园园 LIU Ying;PAN Mei-yu;WAN Yuan-yuan(Xuchang No.2 People's Hospital,Xuchang Henan 461000,China)

机构地区：[1]许昌市第二人民医院,河南许昌461000

出　　处：《抗感染药学》2023年第4期398-402,共5页Anti-infection Pharmacy

摘　　要：目的:分析医院下呼吸道感染(lower respiratory tract infection,LRTI)患儿发生抗菌药物相关性腹泻(antibiotic-associated diarrhea,AAD)的影响因素,为临床AAD的防治提供参考。方法:选取2020年3月—2022年3月许昌市第二人民医院收治的98例使用抗菌药物治疗的LRTI患儿作为研究对象,根据是否发生AAD将其分为AAD组(n=17)和非AAD组(n=81),采集患儿的年龄、性别、住院时间、抗菌药物使用情况、相关实验室指标、侵入性操作等信息,分析患儿发生AAD的影响因素,并依此构建预测模型。结果:单因素分析结果显示,LRTI患儿发生AAD与其年龄、营养不良、住院时间、抗菌药物使用时间、抗菌药物联用状况、激素使用与否、侵入性操作、使用微生态制剂、菌群失调程度间有相关性(P<0.05);而多因素Logistic回归分析结果显示,其中患儿的年龄≤3岁、营养不良、抗菌药物使用时间>14 d、抗菌药物联用、使用激素、发生侵入性操作、使用微生态制剂、菌群失调程度与AAD的发生密切相关(P<0.05),是LRTI患儿发生AAD的独立危险因素;ROC分析显示,上述8个独立危险因素对LRTI患儿发生AAD的预测值为0.823,敏感度为82.47%,特异度为90.82%。结论:LRTI患儿发生AAD于患儿的年龄、营养不良、抗菌药物使用时间、抗菌药物联用、激素使用、侵入操作、使用微生态制剂和菌群失调程度紧密相关,临床应针对高危患儿采取措施积极干预,以减少或避免AAD发生风险。Objective:To analyze the influencing factors of antibiotic-associated diarrhea(AAD)in children with lower respiratory tract infection(LRTI)in the hospital,and provide reference for the prevention and treatment of AAD in the clinical practices.Methods:98 children with LRTI who were treated with antibacterial drugs in Xuchang No.2 People's Hospital from March 2020 to March 2022 were selected as the research subjects,and they were divided into AAD group(n=17)and non-AAD group(n=81)according to the occurrence of AAD.The information such as the age,gender,length of hospital stay,use of antibacterial drugs,related laboratory parameters,and invasive procedures of the children was collected,the influencing factors of AAD in the children were analyzed,and the predictive model was constructed accordingly.Results:The univariate analysis showed that the occurrence of AAD in children with LRTI was correlated with the age,malnutrition,length of hospital stay,duration of antibacterial drug use,combined use of antibacterial drugs,use of hormones,invasive procedures,use of probiotics,and the degree of flora imbalance(P<0.05);and the multivariate Logistic regression analysis showed that the occurrence of AAD was closely related to the age of not more than 3 years old,malnutrition,use of antibacterial drugs for more than 14 days,combined use of antibacterial drugs,use of hormones,occurrence of invasive procedures,use of probiotics,and the degree of flora imbalance(P<0.05),which were independent risk factors for AAD in children with LRTI;ROC analysis showed that the above 8 independent risk factors had a predictive value of 0.823 for the occurrence of AAD in children with LRTI,with a sensitivity of 82.47%and a specificity of 90.82%.Conclusion:The occurrence of AAD in children with LRTI is closely related to the age,malnutrition,duration of antibacterial drug use,combined use of antibacterial drugs,use of hormones,invasive procedures,use of probiotics,and the degree of flora imbalance of the children.Clinically,active interventions s

关 键 词：下呼吸道感染 抗菌药物相关性腹泻 风险因素 预测模型 

分 类 号：R181.32[医药卫生—流行病学]