| Objective:To analyze and summarize the clinical characteristics,the drug resistance and risk factors of extended-spectrum β-lactamases(ESBLs)producing of Escherichia coli(E.coli)bloodstream infection,in children,helpful for clinical diagnosis and treatment,which,not only for guiding rational application of antibacterial drugs and correct selection of antibiotics,but also providing evidence for early clinical diagnosis and treatment.Methods:The clinical data and bacterial susceptibility of 219 children with E.coli bloodstream infection standards and clinical symptoms admitted to Jiangxi Children’s Hospital,From January 2016 to December 2018,were collected to analyze,then divide the children into ESBLs-producing and non-ESBLs-producing groups according to whether E.coli strains produce ESBLs or not,compare the resistance,adopt indicators such as rate and ratio to described statistically,and the distribution differences between groups were compared using chi-square test and non-parametric test.At the same time,the risk factors of ESBLs producing E.coli bloodstream infection were further analyzed by univariate and multivariate Logistic regression analysis.Results:1、The age of the 219 children with E.coli bloodstream infections was 0-1 years old,accounting for 84.5%,of which male children accounted for 70.3%.The most Department is the Department of Neonatology and Hematology.Fever was the most common clinical manifestation(101 cases,46.1%),and the most common complications were digestive system diseases(79 cases,36.1%).In laboratory examination: 110 cases of children with peripheral blood leukocytes >10×109/L,accounting for 50.2%;73 cases of children with hemoglobin <100g/L,accounting for33.3%;62 cases of children with peripheral blood neutrophil ratio>70 %,accounting for 28.3%.29 cases of children used ventilator during treatment,accounting for13.2%.The condition of most children improved after treatment(162 cases,74.0%),and only 5 cases deteriorated and died.2、 The drug susceptibility results indicated that 66 ESBLs-producing strains(30.1%),153 were not ESBLs-producing strains(69.9%),and the resistance rate of ESBLs-producing E.coli to commonly used antibacterial drugs was higher than that of non-ESBLs-producing strains.The resistance rate of the two groups(except for amikacin)was statistically different(P<0.05);The resistance rate of ESBLsproducing E.coli to cefepime,ceftazidime and cefotaxime was >85.0%;non-ESBLsproducing E.coli The highest resistance rate of E.coli to commonly used antibacterial drugs was compound trimethoprim(52.9%),followed by gentamicin(30.1%).3、Premature delivery,impaired liver and kidney function,shock,multiple organ failure,underlying diseases,catheterization,use of ventilator,use of antibacterial drugs before admission,body temperature <36℃,peripheral blood white blood cells<4×109/L,and Hospitalization time> 7 days,Univariate analysis indicated,could increase the risk of E.coli bloodstream infection that produces ESBLs.Then with further multivariate logistic regression analysis,premature delivery,impaired liver and kidney function,shock,multiple organ failure,underlying diseases,catheterization,use of ventilator,body temperature <36 ℃ were independent risk factors for ESBLs-producing E.coli bloodstream infection.Conclusion:1、 Children,aged 0-1,with Escherichia coli bloodstream infection,were the most common,accounting for 84.5%.2、 The resistance rate of ESBLs-producing E.coli strains to commonly used antibacterial drugs in bloodstream infection was higher than that of non-ESBLsproducing strains,and the resistance rate of ESBLs-producing E.coli strains to cephalosporins is as high as 85%.3、 E.coli strains producing ESBLs were most sensitive to amikacin and carbapenem antibiotics.4、 The independent risk factors,for ESBLs-producing E.coli bloodstream infection,were Premature delivery,impaired liver and kidney function,shock,multiple organ failure,underlying diseases,catheterization,use of ventilator,body temperature <36℃. |
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