影响耐碳青霉烯类肺炎克雷伯菌感染患儿死亡的危险因素分析

Analysis on Risk Factors Influencing Death of Children with Carbapenem-resistant Klebsiella Pneumonia Infection

目的:调查并分析影响耐碳青霉烯类肺炎克雷伯菌感染(CRKP)患儿死亡的危险因素。方法:对2013年3月—2019年3月在我院进行治疗209例CRKP患儿资料予以回顾性分析,依据患儿预后情况将其分为死亡组(n=18)和存活组(n=191),比较两组患儿相关资料,对影响患儿死亡危险因素进行分析。结果:单因素分析结果显示两组患儿在体质量指数,白蛋白水平,住院时间,是否进行侵入性操作,治疗使用抗生素时间,治疗使用抗生素种类,治疗使用糖肽类、头孢类以及碳青霉烯类抗菌药物等因素之间比较差异有统计学意义(P<0.05),多因素Logistic分析结果显示,侵入性操作、治疗使用抗生素时间、抗生素种类以及碳青霉烯类抗菌药物为影响CRKP患儿死亡危险因素(P<0.05),而体质量指数,白蛋白水平,住院时间,治疗使用糖肽类、头孢类抗菌药物不是影响CRKP患儿死亡的危险因素(P>0.05)。结论:CRKP患儿应该加强侵入操作管理,合理把握抗生素使用时间,规范使用抗生素以改善此类患儿的预后。

Objective:To investigate and analyze risk factors influencing death of children with Carbapenem-resistant Klebsiella pneumonia(CRKP)infection.Methods:A retrospective analysis was performed on the data of 209 CRKP children who were treated in the hospital from March 2013 to March 2019.They were included in death group(n=18)and control group(n=191)according to their prognosis.The related data were compared between the two groups.The risk factors influencing their death were analyzed.Results:The results of univariate analysis showed there were significant differences in body mass index,albumin level,hospitalization time,invasive operation,antibiotic usage time,antibiotic usage types,usage of glycopeptides,cephalosporins,carbapenems antibiotics between the two groups(P<0.05).The results of multivariate Logistic analysis showed invasive operation,antibiotic usage time,antibiotic usage types and usage of carbapenem antibiotics were risk factors influencing death of CRKP children(P<0.05)while,body mass index,albumin level,hospitalization time,glycopeptides,cephalosporin antibiotics were not risk factors(P>0.05).Conclusion:CRKP children should strengthen invasive operation management,reasonably grasp antibiotic usage time,and regulate antibiotics usage to improve their prognosis.