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下呼吸道感染的危险因素:系统评价和荟萃分析。

Risk factors of lower respiratory tract infection caused by : Systematic review and meta-analysis.

机构信息

Department of Infectious Diseases, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

College of Medicine, Institute of Pharmaceutical Innovation, Wuhan University of Science and Technology, Wuhan, Hubei, China.

出版信息

Front Public Health. 2023 Jan 10;10:1035812. doi: 10.3389/fpubh.2022.1035812. eCollection 2022.

Abstract

OBJECTIVE

To systematically evaluate the risk factors of lower respiratory tract infection caused by for better clinical treatment.

METHODS

PubMed, Embase, the Cochrane Library, Web of Science, China Journal full-text Database (CNKI), Wanfang Database (WanFang Data), VIP (VIP), and China Biomedical Literature Database (CBM) were selected and published by June 2022 about the risk factors of lower respiratory tract infection of . Two researchers independently screened the literature, extracted data, and quality evaluation according to the inclusion and exclusion criteria. RevMan 5.4 software was used for meta-analysis.

RESULTS

A total of 18 articles were included, including 10 in English and 8 in Chinese. Meta analysis showed that the risk factors of lower respiratory tract infection caused by included disease severity, hospitalization days, use of glucocorticoids, invasive procedures, use of broad-spectrum antibiotics and use of more than 3 Antibiotics. The OR values of patients with hospitalization, mechanical ventilation, use of more than 3 Antibiotics, endotracheal intubation and tracheotomy were the highest. Specific hospitalization days (OR = 14.56, 95% CI: 6.1223.01), mechanical ventilation (OR = 14.16, 95% CI: 5.8534.3), use of more than 3 Antibiotics (OR = 6.21, 95% CI: 1.2431.14), tracheal intubation (OR = 6.07, 95% CI: 1.973.64), tracheotomy (OR = 3.77, 95% CI: 1.09~13.04).

CONCLUSION

There are many risk factors for lower respiratory tract infection of , which can occur in patients with severe illness, high APACHE-II score, invasive procedures, and the need for broad-spectrum antibiotics. In terms of the host, these patients are characterized by impaired immune function, severe illness and long-term hospitalization, which objectively leads to the infection of . Therefore, strengthening the monitoring, prevention and control of patients with risk factors of infection is conducive to reducing the risk of infection and death.

摘要

目的

系统评价 引起下呼吸道感染的危险因素,以便更好地进行临床治疗。

方法

计算机检索 PubMed、Embase、The Cochrane Library、Web of Science、中国期刊全文数据库(CNKI)、万方数据库(WanFang Data)、维普数据库(VIP)和中国生物医学文献数据库(CBM),搜集关于 引起下呼吸道感染危险因素的相关文献,检索时限均为建库至 2022 年 6 月。由 2 位研究者按照纳入与排除标准独立筛选文献、提取资料并评价纳入研究的质量后,采用 RevMan 5.4 软件进行 Meta 分析。

结果

共纳入 18 篇文献,其中英文文献 10 篇,中文文献 8 篇。Meta 分析结果显示, 引起下呼吸道感染的危险因素包括疾病严重程度、住院天数、使用糖皮质激素、有创操作、使用广谱抗生素和使用抗生素种类≥3 种,住院、机械通气、使用抗生素种类≥3 种、气管插管和气管切开患者的 OR 值最高。具体住院天数(OR=14.56,95%CI:6.1223.01)、机械通气(OR=14.16,95%CI:5.8534.3)、使用抗生素种类≥3 种(OR=6.21,95%CI:1.2431.14)、气管插管(OR=6.07,95%CI:1.973.64)、气管切开(OR=3.77,95%CI:1.09~13.04)。

结论

引起下呼吸道感染的危险因素较多,可发生于病情严重、APACHE-II 评分高、有创操作及需要使用广谱抗生素的患者,从宿主角度看,这些患者的特点是免疫功能受损、病情严重和长期住院,客观上导致感染的发生。因此,加强对 感染危险因素患者的监测、预防和控制,有利于降低感染和死亡风险。

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