Li Fuxing, Zhu Junqi, Hang Yaping, Chen Yanhui, Gu Shumin, Peng Suqin, Fang Youling, Hu Longhua, Xiong Jianqiu
Department of Jiangxi Provincial Key Laboratory of Medicine, Clinical Laboratory of the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China.
Department of Nursing, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China.
Infect Drug Resist. 2023 Aug 2;16:4977-4994. doi: 10.2147/IDR.S419699. eCollection 2023.
This research aimed to investigate the variations in clinical features and prognosis of HABP caused by and . We also aimed to evaluate the risk variables related to 30-day death in the investigated groups.
A single-center retrospective cohort research lasting four years was performed. A total of 117 patients with HABP were involved in this research. The primary prognosis was 30-day death.
Among 117 patients with HABP, 60 patients were infected with (KP-HABP), and 57 patients were infected with (E. coli-HABP). A higher proportion of males, ICU admission, undergoing tracheotomy and trachea cannulation, carbapenem-resistant strains, inappropriate empirical therapy (IET), immune compromise, diabetes mellitus, and sepsis were observed in the patients with KP-HABP (all < 0.05). Meanwhile, the median SOFA score and Pitt score were significantly ( < 0.001) higher in the KP-HABP group compared to the E. coli-HABP group. The 30-day death was 48.33% in the KP-HABP group and 24.56% in the E. coli-HABP group ( = 0.008). After adjusting for the main covariates, the hazard ratios for 30-day mortality in KP-HABP were 1.58 (95% CI:0.80-3.12), 3.24 (95% CI:1.48-7.06), 5.67 (95% CI:2.00-16.07), and 5.99 (95% CI:2.10-17.06), respectively. Multivariate logistic regression models revealed that IET, hypoproteinaemia, cerebral vascular disease (CVD), and SOFA score ≥ 5.0 were the independent risk variables for 30-day death in KP-HABP. Simultaneously, SOFA score ≥ 4.0 and Pitt score ≥ 2.0 were independent risk factors for 30-day mortality in E. coli-HABP.
The clinical features of HABP vary depending on whether it is caused by or . KP-HABP patients have higher 30-day mortality than E. coli-HABP patients. To ensure greater validity, it is necessary to further verify this conclusion using a larger sample size.
本研究旨在调查由[具体病原体1]和[具体病原体2]引起的医院获得性细菌性肺炎（HABP）的临床特征和预后差异。我们还旨在评估所研究组中与30天死亡相关的风险变量。
进行了一项为期四年的单中心回顾性队列研究。共有117例HABP患者参与本研究。主要预后指标为30天死亡率。
在117例HABP患者中，60例感染[具体病原体1]（KP-HABP），57例感染[具体病原体2]（大肠杆菌-HABP）。KP-HABP患者中男性比例更高、入住重症监护病房、接受气管切开术和气管插管、耐碳青霉烯类菌株、经验性治疗不当（IET）、免疫功能低下、糖尿病和脓毒症的比例更高（均P<0.05）。同时，与大肠杆菌-HABP组相比，KP-HABP组的序贯器官衰竭评估（SOFA）评分中位数和皮特（Pitt）评分显著更高（P<0.001）。KP-HABP组的30天死亡率为48.33%，大肠杆菌-HABP组为24.56%（P=0.008）。在调整主要协变量后，KP-HABP患者30天死亡率的风险比分别为1.58（95%置信区间：0.80-3.12）、3.24（95%置信区间：1.48-7.06）、5.67（95%置信区间：2.00-16.07）和5.99（95%置信区间：2.10-17.06）。多因素逻辑回归模型显示，IET、低蛋白血症、脑血管疾病（CVD）和SOFA评分≥5.0是KP-HABP患者30天死亡的独立风险变量。同时，SOFA评分≥4.0和Pitt评分≥2.0是大肠杆菌-HABP患者30天死亡率的独立危险因素。
HABP的临床特征因病因是[具体病原体1]还是[具体病原体2]而异。KP-HABP患者的30天死亡率高于大肠杆菌-HABP患者。为确保更高的有效性，有必要使用更大样本量进一步验证这一结论。
