儿童各类标本中产超广谱β-内酰胺酶菌危险因素研究

Risk Factors of Bacteria Producing Extended-spectrum Beta-lactamases(ESBLs) from Children′ Various Types of Specimens

目的研究儿童各类标本中产超广谱β-内酰胺酶菌(ESBLs)的危险因素,为临床预防与控制产ESBLs菌株的传播和流行提供参考依据。方法随机抽取山西省儿童医院2007年1月-2009年4月各类标本中ESBLs阳性和阴性病例各100份进行病例对照研究。结果单因素分析结果显示,男性、年龄<1岁、有既往病史、内科、肺炎、医院感染、入院前使用抗菌药物均是ESBLs的危险因素;入院时白细胞数偏高和中性粒细胞百分比偏高是ESBLs的保护因素;ESBLs与手术、输血及其他侵入性操作的相关性未见统计学意义;多因素非条件Logistic回归显示男性、有既往病史、医院感染、入院前使用抗菌药物、内科是产ESBLs的危险因素,有肛管是保护因素。结论提高对具有相关危险因素患儿的细菌学送检率,对预防与控制ESBLs细菌的传播和流行有重要意义。

OBJECTIVE To study the risk factors of extended-spectrum beta-lactamases （ESBLs） producing bacteria infection in children, and provide reference to prevent and control the prevalence of bacterial strain of ESBLs. METHODS In a case and control studys the samples were selected randomly from 2007 to 2009 in the Children＇s Hospital of Shanxi Province. The samples of case and control were all 100. RESULTS Х^2 Test showed that boy and baby, previous history, pneumonia, medical ward, hospital infection and using antibiotics before admission to hospital were the risk factors; t-test showed that high white blood cell and neutrophil were the protective factors; Logistic regression showed that boy , previous history, hospital infection, using antibiotics before admission to hospital and medical ward were the risk factors and anal tube was a protective factor. CONCLUSIONS Increasing the rate of bacteriological test to the children who have the relative risk factors is very important to prevent and control the prevalence of ESBLs strain.