儿童多重耐药肺炎克雷伯菌败血症危险因素及治疗预后分析

目的：探讨儿童多重耐药肺炎克雷伯菌败血症的危险因素、治疗方法以及临床预后。方法回顾分析37例多重耐药肺炎克雷伯菌感染败血症患儿的临床资料。结果早产、双胎、低体重出生、侵入性操作史、中性粒细胞减少以及围生期窒息史均是败血症患儿的危险因素；多重耐药率为94.9%；经验性应用碳青霉烯类药物治愈率达62.5%，4例死亡，均检出产ESBLs菌株。结论肺炎克雷伯菌败血症患儿存在严重多重耐药，产ESBLs的检出率高，长期动态监测患儿的肺炎克雷伯菌耐药趋势，积极筛查存在多重耐药菌者，合理应用抗生素至关重要。

Risk factors and clinical outcomes for multidrug resistant klebsiella pneumoniae bloodstream infections in children

Objective To investigate the risk factors, treatment and clinical outcomes for multidrug resistant（MDR） klebsiella pneumoniae bloodstream infections （KP-BSIs）in children. Methods The Clinical data of 37 children with MDR KP-BSIs were retrospectively analyzed. Results Premature birth, twins, low birth weight,history of invasive procedures,neutropenia and perinatal asphyxia were risk factors for MDR KP-BSIs in children.multi-drug resistance was 94.9%;empirical application of carbapenems vinyl drugs cure rate was 62.5%, four cases of death,strains producing ESBLs were detected. Conclusion MDR of KP-BSIs was serious,and the detection rate of ESBLs-producing was high,to long-term trends in the dynamic monitoring, Screening for the presence of multi-drug resistant positive persons,rational use of antibiotics was essential.