Risk Factors And A Risk Nomogram Model Construction Of Carbapenem-Resistant Enterobacteriaceae Infection In Children

Objective: To determine the risk factors of CRE infection in children,and to construct and evaluate the risk nomogram model.Methods: 1.Pub Med,China Biology Medicine disc,Web of Science,Wan fang Data,CNKI Database were searched to obtain the articles on risk factors for the colonization or infection of carbapenem-resistant Enterobacteriaceae in children published up to May 31,2021.Rev Man5.3 software was used to perform the Meta analysis.2.A total of 119 cases in pediatrics and pediatric intensive care unit of The First Hospital of Lanzhou University were analyzed to explore the independent risk factors of CRE infection in children,and a risk nomogram model was constructed.The effectiveness of the model was evaluated internal validation.Results: 1.13 articles were included in Meta analysis,with 1501 samples in total.The results showed that invasive operation,ICU admission,history of antibiotic use,and 1-minute Apgar score ≤7 were risk factors for the colonization or infection of carbapenem-resistant Enterobacteriaceae in children.2.Multivariate analysis showed that length of hospitalization（OR=1.124）,neonates（OR=5.864）,ICU admission（OR=9.445）,third-generation cephalosporins（OR=4.951）were independent risk factors for CRE infection in children.The above risk factors were included and the risk nomogram model was established.Bootstrap method was used for internal verification,and the bias-corrected curve fitted well with the ideal curve.The ROC curve was drawn,and the consistency index was 0.914.H-L test showed that P=0.819 > 0.05,indicating that the model had a good predictability.Conclusion: Length of hospitalization,neonates,ICU admission and use history of third-generation cephalosporins are independent risk factors of infection in children.The risk nomogram model established based on length of hospitalization,neonates,ICU admission and use history of third-generation cephalosporins can well predict the risk of CRE infection in children,and provide better guidance for hospital infection management.