Risk Factors for Carbapenem-resistant Pseudomonas aeruginosa Infection in Children

作者全名："Li, Lu; Huang, Yanfeng; Tang, Qiqin; Zheng, Yuqiang"

作者地址："[Li, Lu; Huang, Yanfeng; Tang, Qiqin] Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Minist Educ,Chongqing Key Lab Pediat, Dept Infect,Childrens Hosp,Key Lab Child Dev & Di, Chongqing, Peoples R China; [Zheng, Yuqiang] Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Minist Educ,Key Lab Child Dev & Disorders, Dept Clin Lab,Childrens Hosp,Chongqing Key Lab Pe, Chongqing, Peoples R China"

通信作者："Huang, YF (通讯作者)，Chongqing Med Univ, Childrens Hosp, 2 Jinyu Ave, Chongqing, Peoples R China."

来源：PEDIATRIC INFECTIOUS DISEASE JOURNAL

ESI学科分类：IMMUNOLOGY

WOS号：WOS:000825776800024

JCR分区：Q2

影响因子：3.6

年份：2022

卷号：41

期号：8

开始页：642

结束页：647

文献类型：Article

关键词：Pseudomonas aeruginosa; carbapenem resistance; risk factors; children

摘要："Background: Carbapenem-resistant Pseudomonas aeruginosa (CRPA) is rapidly emerging as a life-threatening nosocomial infection. The study aimed to identify the risk factors for CRPA infection in children, especially antimicrobials use and invasive procedures. Methods: A retrospective study was conducted in the Children's Hospital of Chongqing Medical University, which involved a cohort of patients with PA infection from January 2016 to December 2020. Patients were assigned to a carbapenem-susceptible PA group or to a CRPA group and matched using propensity-score matching. Univariate analysis and multivariate analysis were performed to estimate the risk factors of CRPA. Results: One-thousand twenty-five patients were included in the study but 172 children were analyzed. Several factors were associated with CRPA infection according to univariate analysis (P < 0.05), such as prior treatment with some antimicrobials and invasive procedures. However, only prior exposure to carbapenems (odds ratio [OR]: 0.102; confidence interval [CI]: 0.033-0.312; P < 0.001) and bronchoscopy (OR: 0.147; CI: 0.032-0.678; P = 0.014) during time at risk, previous invasive therapy in the last year (OR: 0.353; CI: 0.159-0.780; P = 0.013), and previous use of beta-lactams/beta-lactamase inhibitors within the last 90 days (OR: 0.327; CI: 0.121-0.884; P = 0.03) were considered independent risk factors by multivariate analysis. Conclusions: Those who had prior exposure to carbapenems and bronchoscopy were high-risk population to develop CRPA infection. The spread of CRPA could be influenced by invasive therapy, and we need pay attention to it. Moreover, we should take restrictions in the clinical use of carbapenems into account."

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