儿童CRKP感染的临床特征及预后不良危险因素研究  

Clinical characteristics of children patients with carbapenem resistant Klebsiella pneumoniae infection and risk factors for poor prognosis

作　　者：付春云[1] 张欢 刘敏雪 岑贞娇[1] 阮佳玲 王双杰[1] 胡雪桦[1] FU Chunyun;ZHANG Huan;LIU Minxue;CEN Zhenjiao;RUAN Jialing;WANG Shuangjie;HU Xuehua(Department of Laboratory Medicine,Maternal and Child Health Care Hospital of Guangxi Zhuang Autonomous Region,Nanning,Guangxi 530003,China)

机构地区：[1]广西壮族自治区妇幼保健院医学检验科,南宁530003

出　　处：《重庆医学》2024年第2期198-203,共6页Chongqing medicine

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z-A20220257);广西壮族自治区临床重点专科建设项目(桂卫医发〔2020〕15号)。

摘　　要：目的分析儿童耐碳青霉烯类肺炎克雷伯菌(CRKP)感染的临床特征、耐药性及预后不良危险因素。方法收集2016年8月5日至2020年12月31日该院分离的住院患儿分离CRKP标本,对CRKP阳性患儿临床资料和CRKP耐药性进行分析,对CRKP感染患儿预后良好组和预后不良组的相关资料进行比较,并分析预后不良的危险因素。结果共收集106株非重复CRKP,主要分离自≤1岁患儿。科室分布以新生儿重症医学科和重症医学科为主。CRKP对多种抗菌药物呈高耐药,仅对阿米卡星、左氧氟沙星、庆大霉素、环丙沙星、米诺环素、氯霉素的耐药率<30%。CRKP感染患儿预后不良率达27.4%。logistic多因素回归分析结果显示,多器官功能障碍和贫血是CRKP感染患儿预后不良的独立危险因素(P<0.05)。结论儿童CRKP感染以≤1岁婴儿为主,CRKP对多种抗菌药物呈高度耐药,预后不良的独立危险因素包括多器官功能障碍和贫血。Objective To analyze the clinical characteristics,drug resistance and risk factors for poor prognosis in children patients with carbapenem resistant Klebsiella pneumoniae(CRKP)infection.Methods The samples of CRKP isolated from the children inpatients in this hospital from August 5,2016 to December 31,2020 were collected.The clinical data and drug resistance of CRKP in the patients with CRKP positive were analyzed.The risk factors in the poor prognosis group and good prognosis group of children patients with CRKP infection conducted the correlation analysis.Results A total of 106 strains of non-repetitive CRKP were collected,which were mainly isolated from the patients≤1 year old.The department distribution was dominated by the neonatal ICU and comprehensive ICU.CRKP showed the high resistance to multiple antibacterial drugs,and its resistance rates to amikacin,levofloxacin,gentamicin,ciprofloxacin,minocycline and chloramphenicol were less than 30%.The poor prognosis rate in the children patients with CRKP infection reached 27.4%.The logistic multivariate regression analysis results showed that the multiple organ dysfunction and anemia were the independent risk factors for poor prognosis in the children patients with CRKP infection(P<0.05).Conclusion The children CRKP infection is mainly the infants≤1 years old,and CRKP shows the high resistance to multiple antibacterial drugs,the independent risk factors of poor prognosis include the multiple organ dysfunction and anemia。

关 键 词：耐碳青霉烯类肺炎克雷伯菌 耐药性 危险因素 多器官功能障碍 贫血 

分 类 号：R978[医药卫生—药品]