肺炎患者继发纹带棒状杆菌定植或感染的影响因素

Influencing factors on colonization or infection of Corynebacterium striatum secondary to pneumonia patients

目的 探讨肺炎患者医院获得纹带棒状杆菌定植或感染的影响因素。方法 选择四川大学华西医院2019年1月-2021年7月因肺炎入院患者3 457例的病例资料,根据在住院期间是否培养出纹带棒状杆菌,分为病例组74例和对照组3 383例;通过单因素分析两组相关临床特征的差异,采用Logistic回归模型分析肺炎患者继发纹带棒状杆菌定植或感染患者的影响因素。结果 继发纹带棒状杆菌定植或感染的有74例(2.14%),2020年、2021年纹带棒状杆菌的检出率较2019年增加(P<0.05);单因素分析结果显示,年龄、住院时间,免疫功能(CD、CD、CD)、有创通气及中心静脉置管、合并革兰阴性多药耐药菌感染以及使用广谱抗菌药物对纹带棒状杆菌定植或感染有一定影响(P<0.05);通过Logistic回归进行分析发现:年龄(OR=1.034)、住院时间(OR=1.020)、有创通气(OR=2.932)、中心静脉置管(OR=3.883)、免疫功能低下(OR=1.982)、合并(革兰阴性)多药耐药菌感染(OR=1.953)、广谱抗菌药物使用(OR=9.685)均为肺炎患者继发纹带棒状杆菌定植或感染的影响因素(P均<0.05)。结论 2020年、2021年纹带棒状杆菌的检出率较2019年显著增加,年龄、住院时间,有创通气、中心静脉置管、免疫力低下、合并多药耐药菌感染及广谱抗菌药物的使用是肺炎患者更易定植或感染纹带棒状杆菌的影响因素。

OBJECTIVE To investigate the influencing factors of hospital-acquired Corynebacterium striatum(C.striatum) colonization or infection in pneumonia patient. METHODS The clinical data of 3 457 patients with pneumonia admitted to West China Hospital of Sichuan University from Jan. 2019 to Jul. 2021 were selected and divided into 74 cases of case group and 3 383 cases of control group according to whether C.striatum was cultured for positive or not during hospitalization.The differences in related clinical characteristics between the two groups were analyzed by univariate analysis, and Logistic regression model was used to analyzed the influencing factors of patients with pneumonia secondary to C.striatum colonization or infection. RESULTS There were 74 cases(2.14%) secondary to C.striatum colonization or infection, and the detection rate of C.striatum in 2020 and 2021 was higher than that in 2019(P<0.05).Univariate analysis showed that age, length of stay, immune function(anti-CD3, CD4, CD8), invasive ventilation and central venous catheterization, combined with gram-negative multidrug-resistant bacteria infection, and use of broad-spectrum antibiotics had certain effects on the colonization or infection of Corynebacterium striatum(P<0.05).Logistic regression analysis showed that age(OR=1.034), length of stay(OR= 1.020), invasive ventilation(OR=2.932), central venous catheterization(OR=3.883), immunocompromised(OR=1.982), combined with multi drug resistant bacterial infection(OR=1.953), and use of broad-spectrum antibiotics(OR=9.685) were all the influencing factors of secondary C.Striatum colonization or infection in patients with pneumonia(P<0.05). CONCLUSION The detection rate of C.Striatum in 2020 and 2021 was significantly higher than that in 2019.Age, long-hospital stay, immunosuppression, invasive ventilation, central venous catheterization, multi-resistant G-bacterial infection and broad-spectrum antibiotics usage were the influencing factors for pneumonia patients to be more likely to be colonized or infected with C.striatum.