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Clinical characteristics, risk factor analysis and peripheral blood cell changes for early warning of
1Department of Respiratory Medicine, Tongji Medical College, Liyuan Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Objective:
To explore peripheral blood indicators that may serve as early indicators for multidrug-resistant bacteria (MDR) infections in this demographic, with the goal of providing reference suggestions for the clinical prevention of MDR infections in elderly inpatients.
Methods:
Clinical data of patients were divided into the MDR-infected group (n = 488) and the MDR-uninfected group (n = 233) according to the results of drug sensitivity experiments, risk factors for MDR infection, and peripheral blood indicators related to MDR infections were analyzed using univariate and multivariate logistic regression in conjunction with the construction of a Chi-squared automatic interaction detector (CHAID) decision tree model, considering statistical significance at p < .05.
Results:
Of 721 patients, 488 multidrug-resistant strains were identified. Among them, with Staphylococcus spp. the most prevalent in 148 strains. The most frequent detection of MDR occurred in puncture fluid samples (167 cases). Univariate and multivariate regression analyses revealed that prolonged hospitalization, use of antibiotics preadmission, duration of antibiotics, invasive procedures or recent surgery, and coexisting lung disease were independent risk factors for contracting MDR. Subsequent analysis comparing the aforementioned influences with peripheral blood cells revealed associations between the number of antibiotic treatment days and increased neutrophil-to-lymphocyte ratio (NLR), platelet count-to-lymphocyte ratio (PLR), neutrophils, decreased lymphocytes, and increased eosinophils; preadmission antibiotic use correlated with increased PLR, NLR, neutrophils, and decreased lymphocytes; and invasive manipulation or surgery correlated with increased PLR and NLR.
Conclusions:
Elevated NLR, PLR, neutrophils, lowered lymphocytes, and eosinophils may serve as early indicators of MDR infections in elderly hospitalized patients.
Insights
Peripheral blood indicators like elevated neutrophil-to-lymphocyte ratio (NLR) and platelet count-to-lymphocyte ratio (PLR) can signal multidrug-resistant bacteria (MDR) infections in elderly patients. These findings aid in early clinical prevention strategies for MDR infections.
Area of Science:
- Infectious Diseases
- Hematology
- Geriatrics
Background:
- Multidrug-resistant bacteria (MDR) infections pose a significant threat to elderly hospitalized patients.
- Early detection of MDR infections is crucial for effective treatment and prevention of complications.
- Peripheral blood indicators offer a potential avenue for non-invasive early detection.
Purpose of the Study:
- To identify peripheral blood indicators that can serve as early warning signs for MDR infections in elderly inpatients.
- To provide data for clinical prevention strategies against MDR infections in this vulnerable population.
Main Methods:
- Retrospective analysis of clinical data from 721 elderly inpatients, divided into MDR-infected (n=488) and MDR-uninfected (n=233) groups.
- Univariate and multivariate logistic regression, along with Chi-squared automatic interaction detector (CHAID) decision tree model, were used to analyze risk factors and peripheral blood indicators.
- Statistical significance was determined at p < 0.05.
Main Results:
- Staphylococcus spp. was the most prevalent MDR strain (148/488).
- Independent risk factors for MDR infection included prolonged hospitalization, preadmission antibiotic use, duration of antibiotic therapy, invasive procedures/surgery, and lung disease.
- Elevated neutrophil-to-lymphocyte ratio (NLR), platelet count-to-lymphocyte ratio (PLR), neutrophils, and eosinophils, along with decreased lymphocytes, were associated with MDR infection, particularly linked to antibiotic use and invasive procedures.
Conclusions:
- Elevated NLR, PLR, neutrophils, and eosinophils, coupled with lowered lymphocytes, may act as early indicators of MDR infections in elderly hospitalized patients.
- These hematological markers can inform clinical decision-making for early intervention and prevention of MDR infections.
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