老年下呼吸道感染患者痰液培养细菌分布及新型冠状病毒感染对其分布的影响

Distribution of sputum bacterial pathogens in elderly patients with lower respiratory tract infection and the impact of COVID-19 on them

目的分析老年下呼吸道感染患者痰液培养细菌分布和新型冠状病毒感染(以下简称新冠)对其分布的影响。方法选取2022年10月至2023年1月在该院诊断为下呼吸道感染的167例老年(年龄≥60岁)患者作为研究对象,收集所有研究对象的痰液标本,采用常规方法对其进行细菌培养、分离及鉴定,同时以反转录酶聚合酶链反应(RT-PCR)法进行新冠病毒核酸检测,根据检测结果将研究对象分为新冠组和非新冠组。结果167例患者痰液标本分离细菌200株,主要为肺炎克雷伯菌(30.0%)、铜绿假单胞菌(18.5%)、鲍曼不动杆菌(12.5%)、大肠埃希菌(7.5%)、嗜麦芽窄食单胞菌(7.5%)。非新冠组感染鲍曼不动杆菌患者比例高于新冠组,而感染嗜麦芽窄食单胞菌患者比例低于新冠组,差异均有统计学意义(P<0.05)。结论老年下呼吸道感染住院患者主要细菌为肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌、大肠埃希菌和嗜麦芽窄食单胞菌,新冠病毒感染会影响老年患者下呼吸道感染的病原菌分布。

Objective To analyze the distribution of sputum bacterial pathogens in elderly patients with lower respiratory tract infection and the impact of corona virus disease(COVID-19)on its distribution.Methods A total of 167 elderly patients(age≥60 years)diagnosed with lower respiratory tract infection in this hospital from October 2022 to January 2023 were selected as the research objects.The sputum samples of all the research objects were collected,and the bacteria were cultured,isolated and identified by routine methods.At the same time,the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)nucleic acid was detected by reverse transcriptase polymerase chain reaction(RT-PCR).According to the test results,the objects were divided into COVID-19 group and non-COVID-19 group.Results A total of 200 strains of bacterium were isolated from sputum samples of 167 elderly patients,mainly including Klebsiella pneumoniae(30.0%),Pseudomonas aeruginosa(18.5%),Acinetobacter baumannii(12.5%),Escherichia coli(7.5%)and Stenotrophomonas maltophilia(7.5%).The proportion of patients infected with Acinetobacter baumannii in the non-COVID-19 group was higher than that in the COVID-19 group,and the proportion of patients infected with Stenotrophomonas maltophilia in the non-COVID-19 group was lower than that in the COVID-19 group,and the differences were statistically significant(P<0.05).Conclusion Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter baumannii,Escherichia coli and Stenotrophomonas maltophilia are the main bacteria of lower respiratory tract infection in elderly inpatients.COVID-19 affects the distribution of bacterial pathogens in lower respiratory tract infection in elderly patients.