OBJECTIVE To analyze the clinical characteristics and prognostic influencing factors of carbapenem-resistant Enterobacteriaceae (CRE) infection in hospitalized children, providing a theoretical basis for the management of antibacterial drugs and prevention and control of hospital-associated infection.

METHODS Clinical data of 169 hospitalized children with CRE infection at Maternal and Child Health Care of Guangxi Zhuang Autonomous Region from Jan. 2017 to Dec. 2023 were retrospectively analyzed. Strain identification and drug susceptibility testing were performed through the DL-96Ⅱ bacterial detection system. Univariate analysis was conducted based on the χ² test, and independent risk factors were screened via multivariate logistic regression model.

RESULTS Among the 169 CRE strains, Klebsiella pneumoniae (98 strains, 57.99%) and Escherichia coli (46 strains, 27.22%) were predominant, primarily isolated from the neonatology department (76 cases, 44.97%) and intensive care unit (51 cases, 30.18%). The main specimen sources were lower respiratory tract secretions (87 strains, 51.48%), followed by venous blood (25 strains, 14.79%). Drug susceptibility results indicated resistance rates exceeding 90% to over ten antibacterial agents, including imipenem and meropenem. Multivariate logistic regression identified prior use of carbapenem before specimen submission and bloodstream infection as independent risk factors for poor prognosis (P < 0.05).

CONCLUSIONS Children with CRE infection exhibit distinct dominant species and severe multidrug resistance. Carbapenem use history and bloodstream infection are independent risk factors for poor prognosis. Targeted antibacterial drug management strategies and strengthened infection control in neonatology department and pediatric intensive care units are recommended to optimize clinical prognosis.