Beta-Lactamase Gene Expression Level of Hospital-Acquired CRAB Isolated from Children in Picu

Figures & data

Figure 1 Exclusion criteria and inclusion criteria.

Figure 2 The different Specimen culture site including sputum, blood culture, urine culture, cerebra fluid, pleural fluid, ascites and bronchoalveolar lavage fluid from patients.

Figure 3 Resistance of Acinetobacterbaumannii. Drug resistance about Acinetobacterbaumannii includes amikacin/gentamicin, sulbactam and cefoperazone, cefepime/ceftazidime/ampicillin, ampicillin/sulbactam, piperacillin /tazobactam, compound sulfamethoxazole, and ciprofloxacin/levofloxacin/tetracycline/tigecycline.

Table 1 Comparison Between Carbapenem-Resistant Group and Carbapenem-Sensitive Group

	Carbapenem-Resistant Group (89)	Carbapenem-Sensitive Group (43)	P
Male sex	51	22	0.679
Age (month)	47.65+-46.13	34.48+-43.46	0.122
Previous in-hospital days	14 (18)	9 (13)	0.024
Basic disease	41	19	0.92
Congenital heart disease	14	8	0.678
Inherited metabolic disease	12	6	0.941
Severe pneumonia	45	23	0.753
Sepsis before	13	4	0.419
Shock before	8	4	1
MODS before	3	1	1
MODS after	9	5	0.994
Sepsis after	10	2	0.231
Shock after	7	1	0.405
Glasgow at time of admission in picu	12 (4)	12 (2)	0.321
Mechanical Ventilation without 24 hours in PICU	46	23	0.846
WBC without 24 hours in PICU	10.28 (8.56)	10.8 (7.91)	0.786
PLT without 24 hours in PICU	256.75+-161.13	273.65 (130.32)	0.524
Previous Mechanical Ventilation	81	37	0.571
CRRT	9	4	1
Previous Deep vein catheterization	40	7	0.001
Previous Thoracentesis	15	4	0.237
Previous Catheterization	56	19	0.042
Fever when culture	60	21	0.04
WBC (10^9)	10.6 (7.62)	11.06 (8.7)	0.488
ΔWBC (10^9)	0.57+—6.62	−0.49+—8.04	0.442
ΔCRP (mg/L)	−1.1 (23)	2.05 (15)	0.225
ΔPCT (ng/mL)	0 (1)	0.01 (2)	0.953
oxa-51 like gene	0.90 (2.05)	0.10 (0.30)	0.000
oxa-23 like gene	0.29 (1.23)	0.00 (0.05)	0.000
oxa-24 like gene	0.04 (0.33)	0.05 (0.31)	0.305
Previous ≥3 antiobic therapy	64	24	0.066
Previous carbapenem (meropenem/imipenem) therapy	30	6	0.017
IgG (g/L)	6.23 (5.37)	9.02 (8.44)	0.313
IgM (g/L)	0.77 (0.52)	0.71 (0.79)	0.729
IgA (g/L)	0.55 (0.79)	0.40 (0.68)	0.158
T cell (/ul)	1014 (1935)	1694 (1235)	0.710
B cell (/ul)	324 (536)	666 (520)	0.699
NK cell (/ul)	122 (152)	154 (159)	0.177
CD4 cell (%)	33.2 (21)	32 (10)	0.699
CD8 cell (%)	20.8 (13)	18 (13)	0.177
30-day mortality	19	8	0.714

Note: The meaning of the numbers in the parentheses is Interquartile range.

Table 2 Logistic Regression Analysis About Risk Factors Associated with Carbapenem Resistance

	HR	95% C.I.	P
Previous in-hospital days	1.004	0.979–1.03	0.747
Previous Deep vein catheterization	0.401	0.131–1.228	0.109
Previous Catheterization	0.815	0.295–2.251	0.693
Fever when culture	0.677	0.256–1.793	0.433
Previous carbapenem (meropenem/imipenem) theray	0.31	0.1–0.959	0.042
oxa-23 like gene	0.005	0–0.153	0.002
oxa-51 like gene	0.805	0.567–1.143	0.225

Abbreviations: HR, hazard ratio; CI, confidence interval.

Table 3 Univariate Analysis Comparing Survivors and Non-Survivors at 30 Days from Infection Onset

	Survival (104)	Death (27)	P
Sex	46	14	0.343
Congenital heart disease	18	4	0.877
Inherited metabolic disease	12	6	0.041
Severe pneumonia	62	16	0.35
Sepsis before	12	5	0.445
Shock before	11	1	0.221
MODS before	2	2	0.072
Sepsis after	8	6	0.029
Shock after	6	6	0.015
MODS after	4	4	0.02
Glasgow when admission in picu	12 (3)	12 (4)	0.791
WBC without 24 hours in PICU	10.85 (8.4)	9.5 (8.7)	0.238
PLT without 24 hours in PICU	273.57+-154.06	218.27+-135.72	0.312
WBC (10^9)	10.6 (6.6)	10.7 (10)	0.837
ΔWBC (10^9)	0.23+-8	0.28+-9	0.921
ΔCRP (mg/L)	−1.04 (18)	3.34 (67)	0.012
Albumin (g/L)	34.43+-4.46	31.3+-5.04	0.008
AST (μmol/L)	33.06+-22.42	66.6+-68.3	0.037
ALT (μmol/L)	44.88+-83.93	129.91+-393.29	0.017
Total Bilirubin (μmol/L)	6.64+-3.81	8.43+-6.19	0.004
Creatinine (μmol/L)	20.10+-10.25	21.66+-6.76	0.456
Urea nitrogen (mmol/L)	4.045 (4.38)	5.07 (3.99)	0.806
oxa-51	0.47 (1.95)	0.11 (1.44)	0.65
oxa-24	0.06 (0.73)	0.08 (2.41)	0.712
oxa-23	0.28 (2.4)	0.15 (0.22)	0.181
IgG (g/L)) (93:32)	7.8+-4.91	10.62+-7.05	0.368
IgM (g/L) (93:32)	0.76+-0.44	0.73+-0.52	0.722
IgA (g/L) (93:32)	0.39 (0.59)	0.23 (0.45)	0.324
T cell (/ul)	1435.48+-1407.57	1215.88+-1112.34	0.0929
B cell (/ul)	724.84+-661.55	748.35+-770.91	0.786
NK cell (/ul)	205.98+-226.72	232.76+-342.80	0.387
CD4 cell (%)	30.17+-13.40	30.71+-14.14	0.475
CD8 cell (%)	19.82+-10.06	22.31+-10.69	0.833
Cephalosporins combined with sulbactam (Cefoperazone /Sulbactam:31/56)	50	6	0.023

Notes: the meaning of the numbers in the parentheses is Interquartile range.(Δ)=value of 24 hours after clinical diagnosis of infection- value of 48 hours before infection diagnosis.

Table 4 Cox Regression Analysis About Risk Factors Associated with 30-Day Mortality

	HR	95.0% CI	P
MODS after	3.1	0.602–15.971	0.176
Shock after	2.81	0.969–8.143	0.057
Sepsis after	1.42	0.284–7.088	0.669
Cephalosporins combined with sulbactam	0.26	0.095–0.712	0.009
ALT	1	0.999–1.001	0.749
AST	1	0.995–1.005	0.905
Total Bilirubin (μmol/L)	1.012	0.983–1.043	0.42
Albumin (g/L)	0.935	0.845–1.035	0.193
ΔCRP (mg/L)	1.004	0.996–1.013	0.296

Abbreviations: HR, hazard ratio; CI, confidence interval.