老年抑郁症患者肺部感染病原菌分布及相关因素分析

Distribution of pathogenic bacteria and analysis of related risk factors for pulmonary infection in elderly depression patients

目的研究老年抑郁症患者肺部感染病原菌分布及危险因素。方法回顾性分析宁波市康宁医院2015年1月—2021年6月收治的250例老年抑郁症患者发生肺部感染的危险因素及病原菌分布。结果老年抑郁症患者肺部感染发生率为18.40%。分离出病原菌68株,革兰阴性菌38株,以肺炎克雷伯菌、大肠杆菌为主;革兰阳性菌21株,以凝固酶阴性葡萄球菌和金黄色葡萄球菌为主,真菌9株。肺部感染与年龄、性别、长期卧床、滥用抗菌药物、低蛋白血症、糖尿病、病程时间、吸烟、抑郁症状控制有关(P<0.05)。多因素Logistic回归显示,长期卧床、病程时间长、抑郁症状控制差、糖尿病、吸烟、滥用抗菌药物是肺部感染的危险因素(P<0.05)。结论老年抑郁症患者肺部感染致病菌主要为革兰阴性菌,肺部感染与长期卧床、滥用抗菌药物、糖尿病、病程时间、吸烟及抑郁症状控制有关,临床应对肺部感染的危险因素针对性预防和治疗。

Objective To investigate the distribution of pathogens and the risk factors of pulmonary infection in elderly depression patients.Methods The risk factors and pathogen distribution of pulmonary infection in 250 elderly depression patients admitted to Ningbo Kangning Hospital(here after“our hospital”)from January 2015 to June 2021 were analyzed retrospective-ly.Results The incidence of pulmonary infection in elderly patients with the depression rate of 18.40%.68 stains of pathogenic bacteria were isolated,of which 38 strains were gram-negative,mainly Klebsiella pneumoniae and Bacterium coli,and 21 strains were gram-positive bacteria,mainly coagulase-negative staphylococcus and Staphylococcus aureus.In addition,there were 9 strains of fungus.The pulmonary infection in the elderly depression patients was associated with age,sex,long-term bedridden time,abuse of antibacterial drugs,hypoalbuminemia,diabetes mellitus,duration of disease,smoking history and depression symptoms control(P<0.05).Multivariate Logistic regression analysis showed that long-term bedridden time,abuse of antibacterial drugs,diabetes mellitus,duration of disease,smoking history and poor depression symptoms control were the independent risk factors for the pulmonary infection in elderly depression patients(P<0.05).Conclusion The main pathogenic bacteria of pulmonary infection in the elderly depression patients are Gram-negative bacteria.Pulmonary infections are associated with long-term bedridden time,abuse of antibiotics,diabetes mellitus,duration of disease,smoking history and depression symptoms control.It is necessary for the clinic to put forward to the prevention and treatment of risk factors of pulmonary infection in elderly depression patients.