儿童下呼吸道感染病原菌种类调查及并发哮喘的预测模型构建  

Investigation of pathogenic bacteria species of lower respiratory tract infection in children and construction of prediction model of asthma

作　　者：徐金梅[1] 张德强 王永霞 张利兵[1] XU Jinmei;ZHANG Deqiang;WANG Yongxia;ZHANG Libing(Department of Pediatrics,Yangzhou University Affiliated Hospital,Yangzhou 225000,Jiangsu,China)

机构地区：[1]扬州大学附属医院儿科,江苏扬州225000

出　　处：《中国病原生物学杂志》2024年第7期768-772,共5页Journal of Pathogen Biology

基　　金：江苏省妇幼保健协会科研项目基金(No.FYX202206)。

摘　　要：目的 探讨儿童下呼吸道感染病原菌种类调查及并发哮喘的预测模型构建。方法 选取2020年6月至2023年7月诊治的178例下呼吸道感染患儿作为研究对象,对所有患儿开展细菌分离培养,对分离获取的病原菌实施药物敏感试验;并根据患儿治疗期间是否继发哮喘分为哮喘组(n=36)和非哮喘组(n=142);采用Logistic回归模型分析影响下呼吸道感染患儿继发哮喘的危险因素,并建立综合指数模型;采用ROC曲线分析综合指数预测下呼吸道感染患儿继发哮喘的AUC值、敏感度及特异度。结果 178例下呼吸道感染患儿经细菌培养分离出186株病原菌,其中革兰阳性菌共61株(32.80%),革兰阴性菌共117株(65.73%)。药敏结果显示,金黄色葡萄球菌对万古霉素无耐药性,对青霉素G的耐药率最高,其次为环丙沙星、左氟沙星;肺炎链球菌对亚胺培南、万古霉素无耐药性,对青霉素G的耐药率最高,其次为左氟沙星、苯唑西林;表皮葡萄球菌对亚胺培南、万古霉素无耐药性,对苯唑西林的耐药率最高,其次为青霉素、四环素;大肠埃希菌对亚胺培南无耐药性,对氨曲南的耐药性最高,其次为氨苄西林、头孢曲松;肺炎克雷伯菌对亚胺培南无耐药性,对美罗培南无耐药性,对氨苄西林的耐药性最高,其次为氨曲南、头孢噻肟;铜绿假单胞菌对亚胺培南无耐药性,对氨苄西林的耐药性最高,其次为头孢哌酮、头孢呋辛。哮喘组与非哮喘组在性别、年龄、下呼吸道感染病程、体质量、早产、分娩方式、喂养方式等基线资料比较中,差异无统计学意义(P>0.05);而在哮喘家族史、父母吸烟史、过敏史、IgE、CysLTs、25-(OH)D3等比较中,差异有统计学意义(P<0.05)。Logistic回归模型分析显示,哮喘家族史、父母吸烟史、过敏史及IgE、CysLTs升高和25-(OH)D3下降是影响下呼吸道感染患儿继发哮喘的危险因素(P<0.05)。综合指数预测下呼吸道感染患�Objective To investigate the species of pathogenic bacteria in children with lower respiratory tract infection and establish a prediction model for asthma.Methods A total of 178 children with lower respiratory tract infection diagnosed and treated from June 2020 to July 2023 were selected as the study objects,all of them were isolated and cultured,and drug sensitivity tests were carried out on the isolated pathogens.The children were divided into asthma group(n=36)and non-asthma group(n=142)according to whether they had secondary asthma during treatment.Logistic regression model was used to analyze the risk factors of secondary asthma in children with lower respiratory tract infection,and a comprehensive index model was established.ROC curve was used to analyze the composite index to predict the AUC,sensitivity and specificity of secondary asthma in children with lower respiratory tract infection.Results In 178 children with lower respiratory tract infection,186 strains were isolated by bacterial culture,of which 61 strains(32.80%)were gram-positive and 117 strains(65.73%)were gram-negative.The drug sensitivity results showed that Staphylococcus aureus had no resistance to vancomycin,and the resistance rate to penicillin G was the highest,followed by ciprofloxacin and levofloxacin.Streptococcus pneumoniae had no resistance to imipenem and vancomycin,and the resistance rate to penicillin G was the highest,followed by levofloxacin and oxacillin.S.epidermidis had no resistance to imipenem and vancomycin,and the resistance rate to oxacillin was the highest,followed by penicillin and tetracycline.There was no resistance to imipenem,and the resistance to amtronam was the highest,followed by ampicillin and ceftriaxone.Klebsiella pneumoniae had no resistance to imipenem,no resistance to meropenem,and the highest resistance to ampicillin,followed by amtronam and cefotaxime.Pseudomonas aeruginosa had no resistance to imipenem,and the resistance to ampicillin was the highest,followed by cefoperazone and cefuroxime.There was

关 键 词：儿童 下呼吸道感染 病原菌 哮喘 预测模型 

分 类 号：R725.6[医药卫生—儿科] R446.5[医药卫生—临床医学]