Study on the transmission dynamics and prevention and control strategies of carbapenem-resistant Enterobacteriaceae infections in the pediatric intensive care unit
WANG Qiuhong
SONG Yujing
Abstract：Objective To construct a nomogram prediction model for carbapenem resistant Enterobacteriaceae(CRE)infections in the pediatric intensive care unit(ICU).Methods A retrospective cohort study design was adopted,and 174 pediatric patients admitted to and treated in the ICU of Wolong District Maternal and Child Health Hospital in Nanyang City from October 2019 to November 2023 were included as the study subjects.Based on the bacterial test results,the pediatric patients were divided into a CRE infection group(62 cases)and a non-CRE infection group(112 cases).Multiple logistic regression analysis was used to screen for independent risk factors CRE infection.Based on this,a nomogram prediction model for CRE infection in ICU pediatric patients was constructed.Calibration curves,receiver operating characteristic(ROC)curves,and Hosmer-Lemeshow(H-L)tests were used to evaluate the performance of model;decision curve analysis(DCA)was used to assess the clinical efficacy of the nomogram.Results A total of 84 CRE strains were isolated from 62 pediatric patients with CRE infection,with Klebsiella pneumoniae being the predominant strain(73.81%).The specimens of 62 children with CRE infection mainly came from the respiratory tract(72.58%),followed by blood(11.29%),urine(9.68%),and incision secretions(6.45%).The results of multiple logistic regression analysis showed that age<12 years old,an ICU stay≥10 days,a history of carbapenem antibiotic use,indwelling urinary catheters,indwelling central venous catheters,and mechanical ventilation are independent risk factors for CRE infection in ICU pediatric patients(P<0.05).In ROC analysis,the area under the curve(AUC)was 0.928.The H-L goodness of fit test(χ2=7.976,P=0.436)shows that the model fits well.,the calibration curve showed good fit with the ideal curve.The results of DCA showed that the interventions based on nomograms had good clinical benefits when the probability threshold was between 0.04 and 0.94.Conclusion The nomogram model constructed based on independent risk factors has good predictive ability for CRE infection in ICU pediatric patients and can serve as a reference for the formulation of clinical prevention and treatment strategies.
Keywords：intensive care unitpediatric patientscarbapenem resistant enterobacteriaceae bacteriainfectionrisk factorscolumn chart model
Publication Date：2025-12-30
Online Publishing Date：2025-12-30(First online date of this platform, not the publication date of the document)
Pages：6( 605-610 )