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The prospective evaluation of risk factors and clinical influence of carbapenem resistance in children with gram-negative bacteria infection.

Abstract：

BACKGROUND:Carbapenem-resistant gram-negative (CRGN) infections have been increasing in recent years and associated with significant morbidity, mortality, and health care costs. The aim of this study was to evaluate the epidemiologic and clinical risk characteristics, risk factors, and outcome of CRGN infections and to compare with carbapenem-sensitive gram-negative (CSGN) infections in children. METHODS:Newly diagnosed CRGN infections in hospitalized children younger than age 18 years were prospectively recorded and all patients infected with a CSGN pathogen in the same unit within 48 hours of diagnosis were included in a control group between April 1, 2014, and December 31, 2014. RESULTS:Twenty-seven patients with CRGN infections and 28 patients with CSGN infections were enrolled in this study. Ventilator-associated pneumonia was the most common type of infection in both groups. Prior exposure to carbapenems (relative risk [RR], 11.368; 95% confidence interval [CI], 1.311-98.589), prolonged hospitalization (RR, 5.100; 95% CI, 1.601-16.242) were found to be independent risk factors for acquiring CRGN infections. Septic shock was significantly more frequent in the CRGN group (RR, 9.450; 95% CI, 1.075-83.065). The in-hospital mortality was higher in the CRGN group (RR, 7.647; 95% CI, 1.488-39.290). CONCLUSIONS:Prior carbapenem exposure and prolonged hospitalization are the most important risk factors for acquiring CRGN infections in our hospital. This study demonstrated, similar to previous reports, that carbapenem resistance increases morbidity, mortality, and health care costs.

journal_name

Am J Infect Control

journal_title

American journal of infection control

authors

Sahbudak Bal Z,Bekmezci N,Soylu M,Sen S,Avcu G,Aydemir S,Vardar F

doi

10.1016/j.ajic.2017.08.013

subject

Has Abstract

pub_date

2018-02-01 00:00:00

pages

147-153

issue

2

eissn

0196-6553

issn

1527-3296

pii

S0196-6553(17)30960-4

journal_volume

46

pub_type

杂志文章

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