NHIỄM KHUẨN HUYẾT DO ESCHERICHIA COLI Ở TRẺ EM TẠI BỆNH VIỆN NHI ĐỒNG 1 NĂM 2021 - 2023

Abstract

Objective: To describe the epidemiological, clinical, and antibiotic resistance characteristics of E. coli and the outcome of pediatric sepsis caused by Escherichia coli (E. coli). Subjects and Methods: A case series study was conducted on 57 children aged 2 months to 16 years diagnosed with sepsis caused by E. coli and treated at Children's Hospital 1 from January 1, 2021, to December 31, 2023. Results: The male-to-female ratio was 1.7:1; among them, children aged ≤ 12 months accounted for 71.9%. Thirty-one out of 57 (54.4%) children had community-acquired infections, with the most common source of infection being the gastrointestinal tract (24.6%), followed by the urinary tract (15.8%). Fever was the most common clinical symptom (91.2%), while 28.1% of children had respiratory distress, and 12.3% had shock. Laboratory features included anemia (72.7%), leukocytosis (38.2%), and CRP > 50 mg/L (70.2%). Resistance rates of E. coli to ampicillin were 91.2%; third-generation cephalosporins and carbapenems were 50-70% and 10-16%, respectively, while most strains remained susceptible to amikacin (91.2%). Initial antibiotic therapy was appropriate in 68.4% of cases. Respiratory support was required in 43.9%, with mechanical ventilation used in 48%. The mortality rate in the study was 21.2%, with 58.3% of the deceased cases presenting shock. Conclusion: Sepsis caused by E. coli in children presents with severe clinical manifestations and high mortality rates. The antibiotic resistance rate of E. coli is high.