Incidence of and Risk Factors for Third-Generation Cephalosporin-Resistant Escherichia coli Bloodstream Infections in Children

作者全名："Cheng, Jie; Liu, Ya; Li, Shaojun; Pu, Kaibin; Yang, Lin; Tan, Liping"

作者地址："[Cheng, Jie; Li, Shaojun; Pu, Kaibin; Yang, Lin; Tan, Liping] Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Chongqing Key Lab Child Rare Dis Infect & Immun, Minist Educ,Key Lab Child Dev & Disorders,Children, Chongqing 400014, Peoples R China; [Liu, Ya] Chongqing Youyoubaobei Women & Childrens Hosp, Dept Pediat, Chongqing 401147, Peoples R China"

通信作者："Tan, LP (通讯作者)，Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Chongqing Key Lab Child Rare Dis Infect & Immun, Minist Educ,Key Lab Child Dev & Disorders,Children, Chongqing 400014, Peoples R China."

来源：INFECTION AND DRUG RESISTANCE

ESI学科分类：IMMUNOLOGY

WOS号：WOS:001167038300001

JCR分区：Q2

影响因子：2.9

年份：2024

卷号：17

期号：　

开始页：543

结束页：550

文献类型：Article

关键词：third-generation cephalosporin-resistant; inappropriate use of carbapenems; Escherichia coli; bloodstream infection; children

摘要："Objective: Third-generation cephalosporin-resistant (3GC-R) bloodstream infection (BSI) is associated with poor prognosis. We investigated the incidence of and risk factors for 3GC-R Escherichia coli (E. coli) BSI in children. Methods: Patients with E. coli BSIs who were hospitalized at the Children's Hospital of Chongqing Medical University were retrospectively enrolled. Univariate and multivariate logistic regression analyses were used to identify the independent risk factors for 3GC-R BSI. Results: Two hundred fifty-two children with E. coli BSIs were enrolled. The mortality rate was 11.51% (29/252). The infection rate of 3GC-R E. coli was 48.81% (123/252), and the incidence of E. coli BSI during hospitalization was 18.58 per 1000 person-days. Approximately half (47.22%, 119/252) of the children were infected with extended-spectrum beta-lactamases (ESBLs) produced by E. coli. More than one-third (37.30%, 94/252) of the children were unnecessarily administrated carbapenems. According to our logistic regression analysis, a history of carbapenem administration, an elevated Pediatric Sequential Organ Failure Assessment (pSOFA) score >= 2, and antimicrobial agent administration before blood culture were independently associated with 3GC-R BSI (odds ratio [OR] 2.05, 95% confidence interval [CI] 1.08-3.94, P=0.029; OR 2.00, 95% CI 1.10-3.71, P=0.025, OR 1.86, 95% CI 1.02-3.42, P=0.044, respectively). Conclusion: In this study, the incidence of 3GC-R E. coli BSI among children was retrospectively evaluated. Patients with a history of carbapenem administration, an elevated pSOFA score >= 2 and who were administrated antimicrobial agents before blood culture had an increased risk of 3GC-R E. coli BSI."

基金机构：Chongqing Municipal Health Commission [2022-WSJK-053]; National Clinical Research Center for Child Health and Disorders [NCRCCHD-2022-GP-0X]

基金资助正文："This study was supported by the Chongqing Municipal Health Commission (2022-WSJK-053) and the National Clinical Research Center for Child Health and Disorders (NCRCCHD-2022-GP-0X) . The funders of the study had no role in the study design; data collection or analysis; or article writing, submission or revision."