儿童呼吸道大肠埃希菌感染的耐药性及产ESBLs大肠埃希菌感染危险因素研究OA

Objective To analyze the drug resistance of Escherichia coli infection in children's respiratory tract and the risk factors of extended-spectrum β-lactamase(ESBLs)-producing Escherichia coli infection.Methods A total of 102 children with respiratory tract infection admitted to Xingguo County Maternal and Child Health Hospital from June 2022 to May 2024 were selected as the research objects.The sputum samples of the patients were collected and sent for examination,and drug sensitivity test and bacterial identification were carried out.ESBLs-producing strains of Escherichia coli were detected and screened.According to the detection of ESBLs-producing Escherichia coli,they were divided into ESBLs-producing group and non-ESBLs-producing group.The number and types of pathogenic bacteria detected in children with respiratory tract infection were counted,the drug resistance of isolated Escherichia coli was analyzed,the detection of extended-spectrum β-lactamase produced by Escherichia coli was counted,the drug resistance of ESBLs-producing group and non-ESBLs-producing group to commonly used antibiotics was compared,and the drug resistance of Escherichia coli infection in children with respiratory tract infection and the risk factors of ESBLs-producing Escherichia coli infection were analyzed.Results A total of 102 strains of pathogenic bacteria were isolated:77 strains were Gram-negative bacteria(75.49%),25 strains were Gram-positive bacteria(24.51%).The top three Gram-negative bacteria were Klebsiella pneumoniae(22.55%),Escherichia coli(20.59%)and Pseudomonas aeruginosa(11.76%).The top three Gram-positive bacteria were Staphylococcus aureus(13.73%),Streptococcus pneumoniae(6.86%)and Enterococcus(2.94%).The top three resistance rates of Escherichia coli isolated were ampicillin(90.48%),ampicillin-sulbactam(85.71%),and cotrimoxazole(76.19%).For most drugs,the resistance rate of non-ESBLs-producing strains was lower than that of ESBLs-producing strains(P<0.05).Univariate analysis showed that age,third-generation cephalosporin use,and invasive operation were risk factors for ESBLs-producing Escherichia coli infection(P<0.05).Multivariate Logistic analysis showed that age<3 years old,invasive operation and third-generation cephalosporin use≥3 days were independent risk factors for ESBLs-producing Escherichia coli infection(P<0.05).Conclusion Escherichia coli is the main pathogenic bacteria in children's respiratory tract.One of the important reasons for its drug resistance is ESBLs production.Age<3 years old,invasive operation and third-generation cephalosporin use≥3 days are independent risk factors for ESBLs-producing Escherichia coli infection.Therefore,the selection of antibiotics should be based on the results of drug sensitivity test.