Department of Respiratory and Critical Care Medicine, Provincial School of Clinical Medicine, Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, No. 134 East Street, Gulou District, Fuzhou City, 350001, Fujian Province, China.
The Third Clinical Medical College, Fujian Medical University, Ningde Municipal Hospital, Ningde, 350021, Fujian, China.
BMC Pulm Med. 2024 Jun 22;24(1):291. doi: 10.1186/s12890-024-03102-w.
To investigate the association between meteorological data three days before admission and the status of sputum pathogens culture in hospitalized patients with Acute exacerbation of Chronic obstructive pulmonary disease (AECOPD) and respiratory infections.
Data from 1,370 AECOPD patients (80.66% males, approximately 80% age > 70) with respiratory infections hospitalized in Fujian Provincial Hospital between December 2013 and December 2019 were collected. This cohort comprised, along with concurrent meteorological data from Fuzhou. Group differences were analyzed to compare the meteorological data three days prior to admission between patients with positive sputum pathogen cultures and those without. Logistic regression models were employed to investigate the association between meteorological parameters and the status of sputum pathogen cultures in patients with AECOPD and respiratory infections. Sensitivity analyses was conducted among the hospitalized patients from 2013 to 2016 and 2017-2019. Stratified analysis was performed to explore the factors affecting the effect of temperature differences and their interactions.
578(42.19%) cases had a positive sputum culture report indicating pathogen growth. 323 cases were found with Gram-negative bacteria, 160 with Gram-positive bacteria, and 114 with fungi. Uni-variate analysis revealed statistical differences in DTD three days prior to admission (DTD-3d) between the positive and negative sputum culture groups (p = 0.019). Multivariate analysis indicated that an increase in the risk of positive sputum pathogen cultures was associated with greater DTD three days before admission (DTD-3d), with OR1.657 (95%CI [ 1.328-1.981]). The risk of positive sputum pathogen cultures was higher in groups with greater DTD-3d. The findings were consistent across different admission periods. Stratified analysis showed that patients without respiratory failure were more affected by DTD-3d, and an interaction effect was observed (p < 0.001).
In coastal areas, the diurnal temperature difference three days prior to admission affects the sputum pathogen status in AECOPD patients with respiratory infections.
探讨入院前三天气象资料与慢性阻塞性肺疾病急性加重（AECOPD）合并呼吸道感染患者痰培养病原菌状况的关系。
收集 2013 年 12 月至 2019 年 12 月期间在福建省立医院住院的 1370 例合并呼吸道感染的 AECOPD 患者（80.66%为男性，年龄约 80%＞70 岁）的资料，并收集同期福州气象资料。对两组入院前三天气象资料进行分析，比较阳性痰培养病原菌患者与阴性患者气象资料的差异。采用 Logistic 回归模型分析气象参数与 AECOPD 合并呼吸道感染患者痰培养病原菌状况的关系。对 2013 年至 2016 年和 2017 年至 2019 年住院患者进行敏感性分析，进行分层分析以探讨影响温度差效应及其相互作用的因素。
578 例（42.19%）患者痰培养报告有病原菌生长。323 例为革兰氏阴性菌，160 例为革兰氏阳性菌，114 例为真菌。单因素分析显示，入院前三天日温差（DTD-3d）在阳性和阴性痰培养组之间存在统计学差异（p=0.019）。多因素分析显示，入院前三天 DTD-3d 增加与痰培养阳性病原菌的风险增加相关，OR 值为 1.657（95%CI[1.328-1.981]）。DTD-3d 越大，痰培养阳性病原菌的风险越高。这一发现适用于不同的入院时期。分层分析显示，无呼吸衰竭的患者受 DTD-3d 的影响更大，且存在交互作用效应（p＜0.001）。
在沿海地区，入院前三天的日温差会影响合并呼吸道感染的 AECOPD 患者的痰培养病原菌状况。
