儿童耐碳青霉烯类肠杆菌定植或感染危险因素的Meta分析

doi:10.7499/j.issn.1008-8830.2109025

摘要
图/表
参考文献(24)
相关文章 (15)
点击分布统计
下载分布统计

全文: PDF (693 KB) [HTML]
输出: BibTeX | EndNote (RIS) 背景资料

摘要目的系统评价儿童耐碳青霉烯类肠杆菌定植或感染的危险因素。方法计算机检索PubMed、Web of Science、中国知网、万方、中国生物医学文献数据库，获得各数据库自建库至2021年5月31日关于儿童耐碳青霉烯类肠杆菌定植或感染危险因素的相关文献，采用RevMan 5.3软件进行Meta分析。结果共纳入13篇文献，累计1 501例样本。Meta分析结果显示下列变量是儿童耐碳青霉烯类肠杆菌定植或感染的危险因素（P<0.05）：留置胃管（OR=4.91）、气管插管（OR=5.03）、中心静脉置管（OR=3.75）、留置导尿管（OR=4.11）、机械通气（OR=3.09）、重症监护室住院史（OR=2.39）、外科手术史（OR=3.22）、第三代头孢菌素使用史（OR=2.62）、碳青霉烯类抗生素使用史（OR=3.82）、糖肽类抗生素使用史（OR=3.48）、β-内酰胺酶抑制剂抗生素使用史（OR=2.87）、抗真菌药使用史（OR=2.48）、氨基糖苷类抗生素使用史（OR=2.54）、生后1 min Apgar评分≤7分（OR=2.10）。结论侵入性操作、重症监护室住院史、碳青霉烯类抗生素等抗生素使用史、生后1 min Apgar评分≤7分是儿童CRE定植或感染的危险因素。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	林碧玉
	刘婧婷
	金凤玲

关键词 ：耐碳青霉烯类肠杆菌, 定植, 感染, 危险因素, Meta分析, 儿童

Abstract：Objective To systematically assess the risk factors for the colonization or infection of carbapenem-resistant Enterobacteriaceae in children. Methods PubMed, Web of Science, China National Knowledge Infrastructure Database, Wanfang Data, China Biology Medicine disc were searched to obtain the articles on risk factors for the colonization or infection of carbapenem-resistant Enterobacteriaceae in children published up to May 31, 2021. RevMan 5.3 software was used to perform the Meta analysis. Results A total of 13 articles were included, with 1 501 samples in total. The Meta analysis showed that indwelling gastric tube (OR=4.91), tracheal intubation (OR=5.03), central venous catheterization (OR=3.75), indwelling urinary catheterization (OR=4.11), mechanical ventilation (OR=3.09), history of hospitalization in the intensive care unit (OR=2.39), history of surgical operation (OR=3.22), previous use of third-generation cephalosporins (OR=2.62), previous use of carbapenem antibiotics (OR=3.82), previous use of glycopeptide antibiotics (OR=3.48), previous use of β-lactamase inhibitors (OR=2.87), previous use of antifungal drugs (OR=2.48), previous use of aminoglycoside antibiotics (OR=2.54), and Apgar score ≤7 at 1 minute after birth (OR=2.10) were risk factors for the colonization or infection of carbapenem-resistant Enterobacteriaceae in children (P<0.05). Conclusions Invasive operations, history of hospitalization in the intensive care unit, previous use of antibiotics such as carbapenem antibiotics, and Apgar score ≤7 at 1 minute after birth are risk factors for the colonization or infection of carbapenem-resistant Enterobacteriaceae in children.

Key words： Carbapenem-resistant Enterobacteriaceae Colonization Infection Risk factor Meta analysis Child

收稿日期: 2021-09-05

通讯作者: 金凤玲，女，主任检验师。Email：jfljhk@163.com。 E-mail: jfljhk@163.com

作者简介: 林碧玉，女，硕士研究；

引用本文:

林碧玉,刘婧婷,金凤玲. 儿童耐碳青霉烯类肠杆菌定植或感染危险因素的Meta分析[J]. 中国当代儿科杂志, 2022, 24(1): 96-101.

LIN Bi-Yu,LIU Jing-Ting,JIN Feng-Ling. Risk factors for the colonization or infection of carbapenem-resistant Enterobacteriaceae in children: a Meta analysis[J]. CJCP, 2022, 24(1): 96-101.

链接本文:

http://www.zgddek.com/CN/10.7499/j.issn.1008-8830.2109025 或 http://www.zgddek.com/CN/Y2022/V24/I1/96

	Zhang YW, Wang Q, Yin YY, et al. Epidemiology of carbapenem-resistant Enterobacteriaceae infections: report from the China CRE Network[J]. Antimicrob Agents Chemother, 2018, 62(2): e01882-17. PMID: 29203488. PMCID: PMC5786810. DOI: 10.1128/AAC.01882-17.
	Logan LK. Carbapenem-resistant Enterobacteriaceae: an emerging problem in children[J]. Clin Infect Dis, 2012, 55(6): 852-859. PMID: 22700827. DOI: 10.1093/cid/cis543.
	Magiorakos AP, Burns K, Rodríguez Ba?o J, et al. Infection prevention and control measures and tools for the prevention of entry of carbapenem-resistant Enterobacteriaceae into healthcare settings: guidance from the European Centre for Disease Prevention and Control[J]. Antimicrob Resist Infect Control, 2017, 6: 113. PMID: 29163939. PMCID: PMC5686856. DOI: 10.1186/s13756-017-0259-z.
	4 王俊, 高凯杰, 张玲. 2015-2017年某儿童医院耐碳青霉烯类肠杆菌科细菌分布及耐药性分析[J]. 中国抗生素杂志, 2019, 44(7): 860-863. DOI: 10.3969/j.issn.1001-8689.2019.07.015.
	5 张琴, 许健, 宋培培. 儿童患者检出耐碳青霉烯类抗菌药物肠杆菌科细菌分布特征及耐药性分析[J]. 中国抗生素杂志, 2020, 45(12): 1273-1278. DOI: 10.3969/j.issn.1001-8689.2020.12.012.
	Senchyna F, Gaur RL, Sandlund J, et al. Diversity of resistance mechanisms in carbapenem-resistant Enterobacteriaceae at a health care system in Northern California, from 2013 to 2016[J]. Diagn Microbiol Infect Dis, 2019, 93(3): 250-257. PMID: 30482638. PMCID: PMC7155946. DOI: 10.1016/j.diagmicrobio.2018.10.004.
	7 Ottawa Hospital Research Institute. Newcastle-Ottawa quality assessment scale case control studies[EB/OL]. [2021-08-20].
	Alzomor OA, Alfawaz TS, Abu-Shaheen A, et al. A matched case-control study to assess the carbapenem-resistant Enterobacteriaceae infections among hospitalized children at King Fahad Medical City, Riyadh, Saudi Arabia[J]. Saudi Med J, 2019, 40(11): 1105-1110. PMID: 31707406. PMCID: PMC6901765. DOI: 10.15537/smj.2019.11.24586.
	Chiotos K, Tamma PD, Flett KB, et al. Multicenter study of the risk factors for colonization or infection with carbapenem-resistant Enterobacteriaceae in children[J]. Antimicrob Agents Chemother, 2017, 61(12): e01440-17. PMID: 28971864. PMCID: PMC5700345. DOI: 10.1128/AAC.01440-17.
	Logan LK, Nguyen DC, Scaggs Huang FA, et al. A multi-centered case-case-control study of factors associated with Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae infections in children and young adults[J]. Pediatr Infect Dis J, 2019, 38(5): 490-495. PMID: 30169484. PMCID: PMC6395555. DOI: 10.1097/INF.0000000000002176.
	Singh NP, Choudhury DD, Gupta K, et al. Predictors for gut colonization of carbapenem-resistant Enterobacteriaceae in neonates in a neonatal intensive care unit[J]. Am J Infect Control, 2018, 46(6): e31-e35. PMID: 29803234. DOI: 10.1016/j.ajic.2018.01.007.
	Zhang Y, Guo LY, Song WQ, et al. Risk factors for carbapenem-resistant K. pneumoniae bloodstream infection and predictors of mortality in Chinese paediatric patients[J]. BMC Infect Dis, 2018, 18(1): 248. PMID: 29855274. PMCID: PMC5984460. DOI: 10.1186/s12879-018-3160-3.
	Li Z, Lin XX, Liu CX, et al. Epidemiological characteristics and risk factors of nosocomial carbapenem-resistant Enterobacteriaceae infections in children[J]. Chin Med J (Engl), 2020, 133(22): 2756-2758. PMID: 32784335. PMCID: PMC7725526. DOI: 10.1097/CM9.0000000000001006.
	14 曹阳, 毛静秋, 魏殿军, 等. 新生儿碳青霉烯类耐药肺炎克雷伯菌的耐药性及其定植的危险因素分析[J]. 中华临床感染病杂志, 2015, 8(5): 407-412. DOI: 10.3760/cma.j.issn.1674-2397.2015.05.003.
	15 陈虹宇, 黄双双, 孙丽芳, 等. 儿童检出耐碳青霉烯类肺炎克雷伯菌的影响因素分析[J]. 检验医学与临床, 2021, 18(2): 168-171. DOI: 10.3969/j.issn.1672-9455.2021.02.007.
	16 李秋阳, 金凤玲. 儿科重症监护室耐碳青霉烯类肠杆菌科细菌的分布特征及危险因素分析[J]. 国际检验医学杂志, 2019, 40(16): 1980-1984. DOI: 10.3969/j.issn.1673-4130.2019.16.015.
	马明圣, 王丹华, 孙秀静, 等. 新生儿发生产肺炎克雷伯碳青霉烯酶的肺炎克雷伯菌定植的危险因素分析[J]. 中国当代儿科杂志, 2014, 16(10): 970-974. PMID: 25344173. DOI: 10.7499/j.issn.1008-8830.2014.10.002.
	18 谭莉, 凃敏, 彭威军, 等. 新生儿耐碳青霉烯类肺炎克雷伯菌医院感染相关因素分析[J]. 中华医院感染学杂志, 2018, 28(18): 2811-2814. DOI: 10.11816/cn.ni.2018-182411.
	19 许渝, 黄砚屏, 罗万军. 新生儿耐碳青霉烯类肠杆菌感染影响因素[J]. 中国感染控制杂志, 2020, 19(12): 1098-1101. DOI: 10.12138/j.issn.1671-9638.20206029.
	20 杨欣, 鲁利群, 黄莉, 等. 儿科碳青霉烯类耐药肺炎克雷伯菌感染危险因素及其耐药性[J]. 中华医院感染学杂志, 2020, 30(22): 3470-3473. DOI: 10.11816/cn.ni.2020-206730.
	Mehta AC, Muscarella LF. Bronchoscope-related "superbug" infections[J]. Chest, 2020, 157(2): 454-469. PMID: 31421109. DOI: 10.1016/j.chest.2019.08.003.
	22 朱元元, 徐峰. 留置导管内细菌生物膜感染的研究进展[J]. 中华医院感染学杂志, 2007, 17(1): 115-117. DOI: 10.3321/j.issn:1005-4529.2007.01.043.
	The American College of Obstetricians and Gynecologists Women's Health Care Physicians. Committee opinion No. 644: the Apgar score[J]. Obstet Gynecol, 2015, 126(4): e52-e55. PMID: 26393460. DOI: 10.1097/AOG.0000000000001108.
	Rozaidi SW, Sukro J, Dan A. The incidence of nosocomial infection in the intensive care unit, Hospital Universiti Kebangsaan Malaysia: ICU-acquired nosocomial infection surveillance program 1998-1999[J]. Med J Malaysia, 2001, 56(2): 207-222. PMID: 11771082.