PDF(Pubmed)
Abstract：
UNASSIGNED: To investigate the etiological characteristics and risk factors of extended-spectrum beta-lactamase (ESBL) urinary tract infection (UTI) and construct a corresponding nomogram to predict the probability of ESBL(+) UTI.
UNASSIGNED: We retrospectively reviewed the records among patients experiencing UTI events in Chongqing Medical University Affiliated Children\'s Hospital from 1994 and 2019.
UNASSIGNED: A total of 854 patients with UTI were evaluated and ESBL-producing bacteria increased significantly. Significant potential risk factors of ESBL-UTI were congenital urological abnormalities, vesicoureteral reflux, neurologic disorder, age <12 months, fever and previous use of antibiotics. On logistic regression analysis, neurological disorder (OR =8, 95% CI: 1.845-34.695) and antibiotics administration in the last 3 months (OR =4.764, 95% CI: 3.114-7.289) were identified as an independent significant risk factor for ESBL-UTI. The nomogram generated was well calibrated for all predictions of ESBL+ probability, and the accuracy of the model nomogram measured by Harrell\'s C statistic (C-index) was 0.741.
UNASSIGNED: The current situation of multiple bacterial antibiotic resistance has become a worrisome issue in UTI and early identification of ESBL production is important in terms of appropriate treatment and effective infection control. We may choose broad-spectrum antibiotics as empirical antibiotics for UTI among children with neurological disease and used antibiotic in the last three months.
UNASSIGNED: We retrospectively reviewed the records among patients experiencing UTI events in Chongqing Medical University Affiliated Children\'s Hospital from 1994 and 2019.
UNASSIGNED: A total of 854 patients with UTI were evaluated and ESBL-producing bacteria increased significantly. Significant potential risk factors of ESBL-UTI were congenital urological abnormalities, vesicoureteral reflux, neurologic disorder, age <12 months, fever and previous use of antibiotics. On logistic regression analysis, neurological disorder (OR =8, 95% CI: 1.845-34.695) and antibiotics administration in the last 3 months (OR =4.764, 95% CI: 3.114-7.289) were identified as an independent significant risk factor for ESBL-UTI. The nomogram generated was well calibrated for all predictions of ESBL+ probability, and the accuracy of the model nomogram measured by Harrell\'s C statistic (C-index) was 0.741.
UNASSIGNED: The current situation of multiple bacterial antibiotic resistance has become a worrisome issue in UTI and early identification of ESBL production is important in terms of appropriate treatment and effective infection control. We may choose broad-spectrum antibiotics as empirical antibiotics for UTI among children with neurological disease and used antibiotic in the last three months.
摘要：
■探讨超广谱β-内酰胺酶（ESBL）尿路感染（UTI）的病原学特征和危险因素，并构建相应的列线图预测ESBL（+）UTI的发生概率。
■我们回顾性回顾了1994年和2019年重庆医科大学附属儿童医院发生UTI事件的患者的记录。
■共评估了854例UTI患者，产生ESBL的细菌明显增加。ESBL-UTI的重要潜在危险因素是先天性泌尿系统异常，膀胱输尿管反流,神经系统疾病，年龄<12个月，发烧和以前使用抗生素。在逻辑回归分析中，神经系统疾病(OR=8,95%CI:1.845-34.695)和最近3个月的抗生素使用(OR=4.764,95%CI:3.114-7.289)被确定为ESBL-UTI的独立显著危险因素.生成的列线图对ESBL+概率的所有预测都进行了很好的校准，用Harrell的C统计量（C指数）测量的模型列线图的准确性为0.741。
■多种细菌抗生素耐药性的现状已成为UTI中令人担忧的问题，早期识别ESBL产生对于适当的治疗和有效的感染控制至关重要。在患有神经系统疾病的儿童中，我们可能会选择广谱抗生素作为UTI的经验性抗生素，并在过去三个月中使用过抗生素。
■我们回顾性回顾了1994年和2019年重庆医科大学附属儿童医院发生UTI事件的患者的记录。
■共评估了854例UTI患者，产生ESBL的细菌明显增加。ESBL-UTI的重要潜在危险因素是先天性泌尿系统异常，膀胱输尿管反流,神经系统疾病，年龄<12个月，发烧和以前使用抗生素。在逻辑回归分析中，神经系统疾病(OR=8,95%CI:1.845-34.695)和最近3个月的抗生素使用(OR=4.764,95%CI:3.114-7.289)被确定为ESBL-UTI的独立显著危险因素.生成的列线图对ESBL+概率的所有预测都进行了很好的校准，用Harrell的C统计量（C指数）测量的模型列线图的准确性为0.741。
■多种细菌抗生素耐药性的现状已成为UTI中令人担忧的问题，早期识别ESBL产生对于适当的治疗和有效的感染控制至关重要。在患有神经系统疾病的儿童中，我们可能会选择广谱抗生素作为UTI的经验性抗生素，并在过去三个月中使用过抗生素。
