OBJECTIVE To analyze the drug resistance, laboratory indicators and clinical characteristics of bloodstream infections caused by Enterobacter in children, providing references for early empirical treatment.
METHODS A retrospective analysis was conducted on the clinical data of 302 children (aged 29 days to 12 years) with bloodstream infections caused by Enterobacter (monomicrobial infections) admitted to the Maternity and Child Health Care of Guangxi Zhuang Autonomous Region from Jan. 2017 to Dec. 2023. The drug resistance of Enterobacter and major pathogens were analyzed across different age groups of children. Based on prognosis, the children were divided into a favorable prognosis group (266 cases) and a poor prognosis group (36 cases), and their laboratory indicators and clinical characteristics were compared. Multivariate logistic regression was used to analyze the risk factors for poor prognosis.
RESULTS The major pathogens causing infections were Salmonella, Escherichia coli and Klebsiella pneumoniae. The distribution difference of major pathogens across age groups (29 days-6 months, >6 months-1 year, >1-2 years, >2 years) was statistically significant (P < 0.001). The drug resistance rates of Salmonella to ampicillin, chloramphenicol and sulfamethoxazole/trimethoprim were 68.61%, 54.01% and 44.53%, respectively. E. coli exhibited drug resistance rates of 83.33%, 52.22% and 47.78% to ampicillin, sulfamethoxazole/trimethoprim and cefazolin, respectively. K. pneumoniae showed drug resistance rates exceeding 50% to ampicillin/sulbactam, cefuroxime and cefazolin. Hypoalbuminemia (OR=3.319), sepsis (OR=3.122), ventricular purulent encephalitis (OR=5.104) and prior use of penicillin-class antibacterial drugs before culture positivity (OR=3.374) were identified as risk factors for poor prognosis of the children with Enterobacteriaceae bloodstream infections (P < 0.05).
CONCLUSIONS Bloodstream infections caused by Enterobacter in children predominantly occur in those under 2 years of age, with Salmonella, E. coli and K. pneumoniae as the major pathogens, exhibiting high drug resistance rates to penicillin and cephalosporin antibacterial drugs. Clinical therapeutic regimen should be adjusted early based on laboratory indicators and risk factors to improve prognosis.
DownLoad: