老年呼吸系统疾病患者呼吸道感染的病原菌特征及危险因素 ^*

Analysis of pathogenic bacteria characteristics and risk factors of respiratory tract infection in elderly patients with respiratory system diseases

摘要

目的 分析老年呼吸系统疾病患者呼吸道感染的病原菌特征以及感染的危险因素。方法 选择2023年1月—2024年8月吉林市化工医院收治的106例老年呼吸系统疾病患者作为研究对象。对其痰液样本进行病原微生物培养,依据病原菌感染情况分为感染组和未感染组,分析病原菌特征。采用多因素logistic回归模型分析老年呼吸系统疾病患者呼吸道感染的危险因素。结果 106例呼吸系统疾病老年患者中42例出现呼吸道感染,感染率为39.62%。42例呼吸道感染患者中共检出51株病原菌,其中革兰氏阴性菌检出33株(64.71%),革兰氏阳性菌检出13株(25.49%),真菌检出5株(9.80%)。感染组年龄>80岁、吸烟、合并糖尿病、合并冠心病、糖皮质激素用药>7 d、有侵入性操作、意识状态模糊者占比均高于未感染组(P<0.05),住院时间长于未感染组(P<0.05)。多因素logistic回归分析结果显示:年龄>80岁、糖皮质激素用药>7 d、住院时间、侵入性操作、意识状态模糊均是老年呼吸系统疾病患者呼吸道感染的独立危险因素(P<0.05)。结论 老年呼吸系统疾病患者呼吸道感染的病原菌以革兰氏阴性菌为主,临床实践中可加强对独立危险因素的监测和控制,降低老年呼吸系统疾病患者呼吸道感染的发生风险,改善患者预后。

Abstract

Objective To analyze the pathogenic bacteria characteristics and risk factors of respiratory tract infection in elderly patients with respiratory system diseases. Methods A total of 106 elderly patients with respiratory system diseases in Jilin City Hospital of Chemical Industry from January 2023 to August 2024 were selected as research subjects. The sputum samples were cultured for pathogenic microorganisms. According to the pathogenic bacteria infection, the patients were divided into infection group and non-infection group. The characteristics of pathogenic bacteria were analyzed, and the risk factors of respiratory tract infection in elderly patients with respiratory system diseases were analyzed by a multivariate logistic regression model. Results Among the 106 elderly patients with respiratory system diseases, 42 cases had respiratory tract infection, with the infection rate of 39.62%. 51 strains of pathogenic bacteria were detected in 42 patients with respiratory tract infection, including 33 strains of Gram-negative bacteria (64.71%), 13 strains of Gram-positive bacteria (25.49%) and 5 strains of fungi (9.80%). The proportions of patients with age≥80 years old, smoking, concurrent diabetes mellitus, concurrent coronary heart disease, Glucocorticoid use>7 days, invasive operation and fuzzy state of consciousness in the infection group were higher than those in non-infection group (P<0.05), and the hospitalization time was longer than that in non-infection group (P<0.05). Multivariate logistic regression analysis results revealed that age≥80 years old, glucocorticoid use>7 days, hospitalization time, invasive operation, and fuzzy state of consciousness were all independent risk factors of respiratory tract infection in elderly patients with respiratory system diseases (P<0.05). Conclusion Gram-negative bacteria are the main pathogenic bacteria of respiratory tract infection in elderly patients with respiratory system diseases, and strengthen the monitoring and control of independent risk factors in clinical practice, reduce the risk of respiratory tract infection in elderly patients with respiratory diseases, and improve the prognosis of patients.

关键词

呼吸系统 / 呼吸道感染 / 病原谱 / 危险因素

Key words

Respiratory system / Respiratory tract infection / Pathogen spectrum / Risk factors

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基金资助

^*吉林市医疗卫生指导性计划项目任务书(20220404002)