四川崇州地区小儿肺炎并发抗生素相关性腹泻流行病学特征及危险因素

Epidemiological characteristics and risk factors analysis of pneumonia complicated with antibiotic-associated diarrhea in children in Chongzhou,Sichuan Province

目的分析四川崇州地区小儿肺炎并发抗生素相关性腹泻(AAD)的流行病学特征及危险因素,为小儿肺炎并发AAD的诊治提供理论依据。方法选取2018年6月至2021年6月崇州市人民医院收治的小儿肺炎394例,根据患儿是否发生AAD分为对照组和AAD组,采用单因素分析和logistic回归分析小儿肺炎并发AAD的危险因素。结果小儿肺炎并发AAD 79例(20.05%),ADD组患儿平均年龄明显低于对照组(P<0.05);两组患儿在发病年龄、住院时间、抗生素联合使用种类、抗菌药物应用时间、应用微生态制剂是细菌性比例、抗菌药物类型间差异具有统计学意义(P<0.05);发病年龄<3岁、抗菌药物应用时间≥5d、抗生素联合使用3种、应用头孢菌素抗生素、未应用微生态制剂是小儿肺炎发生AAD的独立危险因素。结论崇州地区小儿肺炎发生AAD的风险较高,其主要病原菌为主要病原菌为念珠菌和大肠杆菌;对于使用头孢类抗菌药物、抗菌药物应用时间长、发病年龄<3岁的患儿,应早期应用微生态制剂,尽量降低小儿肺炎并发AAD的风险。

Objective To analyze the epidemiological characteristics and risk factors of antibiotic-associated diarrhea(AAD)in children with pneumonia in Chongzhou,Sichuan Province,and to provide a theoretical basis for the diagnosis and treatment of AAD in children with pneumonia.Methods A total of 394 children with pneumonia admitted to our hospital from June 2018 to June 2021 were selected and divided into control group and AAD group according to whether the children had AAD.Univariate analysis and logistic regression were used to analyze the risk factors of pediatric pneumonia complicated with AAD.Results There were 79 cases of children with pneumonia complicated with AAD(20.05%).The average age of the ADD group was significantly lower than that of the control group(P<0.05).There were significant differences between the two groups in age of onset,length of hospital stay,type of antibiotics combined use,duration of antibiotics application,proportion of bacterial use of probiotics,and type of antibiotics(P<0.05).The age of onset<3 years old,duration of antibiotics application≥5 days,combined use of three kinds of antibiotics,use of cephalosporin antibiotics,and no use of probiotics are independent risk factors for AAD in children with pneumonia.Conclusion The risk of AAD in children with pneumonia in Chongzhou is high,and the main pathogens are Candida and Escherichia coli.For children with cephalosporin antibiotics use,long application time of antibiotics,and onset age<3 years old,early application of probiotics should be done to reduce the risk of pediatric pneumonia complicated with AAD.