摘要
Abstract
Objective To investigate the clinical characteristics and predictive factors of urinary tract infections (UTIs) in children caused by Extended- Spectyumβ- Lactamase (ESBLs)- producing Escherichia coli (E.coli), and to distinguish cases caused by ESBLs- producing E.coli earlier,and guide the empirical therapy. Methods 195 patients with positive urine culture in our children hospital from January 2011 to December 2012 were included. The clinical characteristics and predictive factors of UTIs caused by ESBLs- producing E.coli were analyzed by Chi- square test and multivariate logistic regression analysis. Results A total of 195 uropathogens were isolated, dominant with E.coli (n=112, 57.44%), including 79 (70.54%) ESBLs- pro-ducing strains.The patients with younger age (<2 years old), urinary tract anomalies, or had the history of antibiotic use be-fore urine culture were more likely be infected with ESBLs- producing E.coli. Compared with non- ESBL UTIs, children with ES-BL UTIs had higher heating temperature, and higher level of C- reactive protein (CRP), however, non- ESBL UTI were associat-ed with higher rate of gross hematuria (P<0.05). The curative effect of empiric therapy for non- ESBL UTIs was significantly better than ESBL UTIs (100% vs 67.80%, P=0.0015),the length of hospital stay was shorter [10 (8,13)vs 12 (9,18), P=0.0245]. Logistic regression analysis showed that the antibiotics usage before urine culture, urinary tract anomalies, fever and high level of CRP were the predictive factors of urinary tract infection caused by ESBLs- producing E.coli. Conclusion The patients with younger age (<2 years old), fever, urinary tract anomalies, high level of CRP are prone to ESBL UTIs, for whomβ- lactamase inhibitor composite antibacterial drugs or carbopenems are recommended as empiric therapy. For the patients without those factors, the third generation cephalosporin could be optional.关键词
大肠埃希菌/ESBLs/尿路感染/儿童Key words
Escherichia coli/Extended- Spectrum/β- Lactamases/Urinary tract infection/Children
