Pathogenic bacteria distribution and risk factors of pulmonary infection in patients with diabetic nephropathy / 公共卫生与预防医学

ABSTRACT

Objective To analyze the distribution of pathogenic bacteria and risk factors of pulmonary infection in patients with diabetic nephropathy (DN), and to provide a theoretical basis for the management and prevention of pulmonary infection in DN patients. Methods A total of 486 DN patients treated in our hospital from March 2018 to December 2020 were selected and divided into experimental group (pulmonary infection, n=178) and control group (no pulmonary infection, n=308) according to the occurrence of pulmonary infection. Sputum samples from all patients were cultured and analyzed. The data of age, gender, length of hospital stay, blood glucose level and renal function indexes of patients in the two groups were collected. Logistic regression was used to analyze the independent risk factors of pulmonary infection in DN patients. Results A total of 178 cases of pulmonary infection in DN patients were included in this study, among which 142 strains of pathogenic bacteria were detected, including 91 strains (64.08%) of gram-negative bacteria, 43 strains (30.28%) of gram-positive bacteria, and 8 strains of fungi (5.63%). The gram-negative bacteria mainly consisted of 39 strains (27.46%) of Klebsiella pneumoniae, 28 strains (19.72%) of Pseudomonas aeruginosa and 18 strains (12.68%) of Acinetobacter baumannii. The gram-positive bacteria included mainly 32 strains (22.54%) of Staphylococcus aureus. There were statistically significant differences between the two groups in age, COPD history, length of hospital stay, HBA1c, serum albumin, volume overload, uremia, and malnutrition (P<0.05). Multivariate logistic regression analysis showed that COPD history, HbA1c, volume overload, serum albumin, uremia and malnutrition were the influencing factors of DN combined with pulmonary infection (P<0.05). Conclusion DN patients are prone to pulmonary infection, and the main pathogens are Klebsiella pneumoniae, Staphylococcus aureus, and Pseudomonas aeruginosa. The main risk factors are COPD history, HbA1c, volume overload, serum albumin, uremia, and malnutrition. It is recommended to supplement nutrition, control blood glucose, delay the decline of organ function, and improve body immunity to prevent pulmonary infection in DN patients.