Drug resistance of extended spectrum beta-lactamase-producing bacteria and risk factors for this bacteria infection in children with hospital acquired pneumonia
HAN Xiao-Hua, DU Yue, LIU Yong, LIU Chun-Feng, SHANG Yun-Xiao, YUAN Zhuang
Department of Pediatrics，Second Affiliated Hospital，China Medical University，Shengyang 110004，China
Abstract：Objective With the extensive use of the third-generation antibiotics, the resistant strains of extended spectrum β-lactamases (ESBLs)-producing bacteria are constantly increasing resulting in an outbreak of nosocomial infectious. This study aimed to investigate the positive rate of ESBLs-producing bacteria and the incidence of their drug resistance to 12 common antibiotics as well as risk factors associated with this bacteria infection in children with hospital acquired pneumonia (HAP). Methods ESBLs-producing bacteria were examined by the disc diffusion confirmatory test and the double disc synergy test in Gram-negative bacteria from sputum in children with HAP. The incidence of drug resistance to 12 common antibiotics was compared between the positive and negative ESBLs-producing bacteria. The risk factors for ESBLs producing bacteria infection were investigated by logistic regressive analysis. Results Forty-three positive ESBLs-producing bacteria strains were isolated from 109 Gram-negative bacteria strains in 95 children with HAP, with a positive rate of 39.4%. Of the bacteria, Escherichia coli accounted for 13.8%, 9.2% for Klebsiella pneumoniae, 8.3% for bowel bacilli, and 8.3% for other bacteria. The incidence of drug resistance of positive ESBLs- producing bacteria to cefozolin, ceclor and cefotaxime was significantly higher than that of non-ESBLs-producing bacteria. In either positive or negative ESBL-producing bacteria, the incidence of drug resistance to imipenem was low (0-11%) and to quinolone and aminoglycoside it was below 40%. Logistic regressive analysis showed that the independent risk factors for ESBLs-producing bacteria infection included the duration of cefotaxime treatment (>3 d), admission to the Intensive Care Unit and invasive operations. The first factor was a predominant one. Conclusions Imipenem, quinolone and aminoglycoside may be recommended in the treatment of ESBLs-producing bacteria infection. Risk for ESBLs-producing bacteria infection is multifactorial. It is necessary to reasonably use antibiotics, stress the asepsis principle and reduce invasive operations as much as possible in order to decrease ESBLs-producing bacteria infection.
HAN Xiao-Hua,DU Yue,LIU Yong et al. Drug resistance of extended spectrum beta-lactamase-producing bacteria and risk factors for this bacteria infection in children with hospital acquired pneumonia[J]. CJCP, 2005, 7(1): 34-38.
