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.
LIU Jian-Hua,LIU Xin-Feng,SHUAI Jin-Feng et al. Risk factors for infection with extended-spectrum beta-lactamase-producing strains in children[J]. CJCP, 2011, 13(12): 959-961.
[1]Knothe H, Shah P, Krenery V, Antal M, Mitsuhashi S. Transferable resistance to cefotaxime,cefoxitin,cefamandole and cefuroxime in clinical isolates of Klebsiella pneumoniae and Serratia marcescens[J]. Infection, 1983, 11(6):315-317.
[2]Grover SS, Sharma M, Chattopadhya D, Kapoor H, Pasha ST, Singh G.Phenotypic and genotypic detection of ESBL mediated cephalosporin resistance in Klebsiella pneumoniae:emergence of high resistance against cefepime, the fourth generation cephalosporin[J]. J Infect, 2006, 53(4): 279-288.
[3]Naumovski L, Quinn JP, Miyashiro D, Patel M, Bush K, Singer SB, et al. Outbreak of ceftazidime resistance due to a novel extended-spectrum beta-lactamase in isolates from cancer patients[J]. Antimicrob Agents Chemother, 1992, 36(9):1991-1996.
[9]Chang FY, Siu LK, Fung CP, Huang MH, Ho M. Diversity of SHV and TEM β-lactamases in Klebsiella pneumoniae:gene evolution in northern Taiwan and two novel β-lactamases, SHV-25 and SHV-26[J].Antimicrob Agents Chemother, 2001, 45(9): 2407-2413.