发育医学电子杂志2026，Vol.14Issue(1)：1-7,27,8.DOI:10.3969/j.issn.2095-5340.2026.01.001
MDRO感染的重症肺炎患儿抗菌疗效影响因素分析
Analysis of factors influencing antibacterial efficacy in children with severe pneumonia infected by MDRO
摘要
Abstract
Objective To investigate the influencing factors of antibacterial efficacy in children with severe pneumonia infected by multidrug-resistant organism(MDRO).Methods The clinical data of 75 children with severe pneumonia infected by MDRO admitted to Anshun City People's Hospital from January 2020 to October 2022 were retrospectively analyzed.The characteristics of MDRO pathogens and the drug resistance of main pathogens were recorded,and sensitive antibiotics were selected for treatment.According to the antibacterial efficacy,the children were divided into effective group(n=19)and ineffective group(n=56).The general data and laboratory indicators[white blood cell count(WBC),procalcitonin(PCT),C-reactive protein(CRP)and neutrophil count]of the two groups were collected.Multivariate Logistic regression analysis was used to identify the factors influencing the antibacterial efficacy in children.The predictive performance and clinical utility of laboratory indicators were evaluated by the receiver operating characteristic(ROC)curve and decision curve.Statistical analysis was performed using t-test,χ2 test.Results A total of 80 MDRO strains were cultured in 75 children,including 12 strains of fungi(15.00%),50 strains of Gram-negative bacteria(62.50%),and 18 strains of Gram-positive bacteria(22.50%).The main drug-resistant bacteria showed that Acinetobacter baumannii,Klebsiella pneumoniae and Pseudomonas aeruginosa were completely resistant to Ampicillin and Cefotaxime,and highly resistant to Ceftriaxone,Piperacillin/Tazobactam and Cefoperazone-Sulbactam.Staphylococcus epidermidis and Staphylococcus aureus were fully resistant to Vancomycin and Erythromycin.The proportion of previous antibiotic use,invasive mechanical ventilation,the length of stay in the pediatric intensive care unit(PICU)≥7 d,and parenteral nutrition in the ineffective group were higher than those in the effective group[47.37%(9/19)vs 23.21%(13/56),31.58%(6/19)vs 8.93%(5/56),89.47%(17/19)vs 10.71%(6/56),31.58%(6/19)vs 8.93%(5/56),χ2 values were 3.993,4.146,37.767,4.146,respectively;all P<0.05].The levels of PCT,WBC,neutrophil count,and CRP in the ineffective group were higher than those in the effective group[(15.56±4.66)µg/L vs(10.81±3.24)µg/L,(12.26±3.60)×109/L vs(8.55±2.57)×109/L,(4.45±1.30)×109/L vs(3.11±0.93)×109/L,(72.72±20.82)µg/L vs(51.98±15.60)µg/L,respectively;t values were 4.912,4.888,4.883,4.585,respectively;all P<0.05]After adjustment,multivariate Logistic regression analysis showed that the levels of serum PCT,WBC,neutrophil count,and CRP were the high-risk factors for antibacterial failure in children with severe pneumonia infected by MDRO(P<0.05).Conclusion The main pathogens in children with severe pneumonia infected by MDRO are Gram-negative bacteria,with Staphylococcus epidermidis and Staphylococcus aureus exhibiting high resistance to Vancomycin and Erythromycin.Furthermore,the levels of serum PCT,WBC,neutrophil count,and CRP demonstrate considerable predictive value and clinical applicability in evaluating the antibacterial efficacy for severe pneumonia infected by MDRO.关键词
多重耐药菌/重症肺炎/病原学特征/实验室指标/耐药性Key words
Multidrug-resistant organism/Severe Pneumonia/Etiological characteristic/Laboratory indicators/Drug resistance引用本文复制引用
蒋训楠,朱晓萍,欧阳洁,卢群,胡伟博..MDRO感染的重症肺炎患儿抗菌疗效影响因素分析[J].发育医学电子杂志,2026,14(1):1-7,27,8.基金项目
贵州省科技计划[黔科合支撑(2020)4Y124号] （2020）
