目的：研究儿童产超广谱β-内酰胺酶（ESBLs）菌株感染的危险因素。方法：回顾性分析2009年2月至2011年1月242例下呼吸道感染住院患儿的临床资料，应用单因素分析和非条件logistic回归分析进行产ESBLs菌株感染的危险因素调查。结果：单因素分析显示6个因素与产ESBLs菌株感染有关：反复口鼻腔吸痰（OR=2.279，P<0.01）、气管插管（OR=3.101，P<0.01）、应用第三代头孢菌素大于3 d（OR=3.628，P<0.01）、入住儿科重症监护病房（PICU）（OR=2.378，P<0.01）、留置鼻饲管（OR=2.460，P<0.01）、预防应用抗生素（OR=1.747，P<0.05）。非条件logistic多元回归分析显示，应用第三代头孢菌素大于3 d（OR=5.672，P<0.01）、反复口鼻腔吸痰（OR=3.917，P<0.01）、气管插管（OR=3.717，P<0.01）、留置鼻饲管（OR=2.961，P<0.01）、入住PICU（OR=3.237，P<0.01）为产ESBLs感染菌的独立危险因素。结论：产ESBLs菌株感染为多因素所致，其中主要与第三代头孢菌素的使用、侵袭性操作、入住PICU密切相关。
Abstract
OBJECTIVE: To study the risk factors for infection with extended-spectrum beta-lactamase (ESBL) producing strains in children. METHODS: The clinical data of 242 pediatric in-patients with lower respiratory tract infections from February 2009 to January 2011 were retrospectively analyzed. The risk factors of ESBL-producing strain infections were investigated using univariate analysis and multivariate logistic regression analysis. RESULTS: Univariate analysis showed that six factors were related with ESBL-producing strain infections: repeated sucking of phlegm (OR: 2.279, P<0.01), tracheal intubation(OR: 3.101, P<0.01), administration of the third generation cephalosporin for more than three days (OR: 3.628, P<0.01), admission to the pediatric intensive care unit (PICU) (OR: 2.378, P<0.01), indwelling of nasogastric tube (OR: 2.460, P<0.01), prophylactic use of antibiotics (OR: 1.747, P<0.05). Multivariate logistic regression showed that the application of the third-generation cephalosporin for more than three days (OR: 5.672, P<0.01), repeated sucking of phlegm (OR: 3.917, P<0.01), tracheal intubation (OR: 3.717, P<0.01), indwelling of nasogastric tube (OR: 2.961, P<0.01）, and admission to PICU (OR: 3.237, P<0.01）were the independent risk factors for the infections. CONCLUSIONS: The infections of ESBL-producing strains are caused by many factors, among which the application of the thirdgeneration cephalosporin for more than three days, invasive operations, and admission to PICU are the independent risk factors.
关键词
超广谱β-内酰胺酶 /
危险因素 /
儿童
Key words
Extended-spectrum beta-lactamase /
Risk factor /
Child
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