临床特征,风险因子分析和周围血液细胞变化,用于早期预警老年患者多药耐药细菌 (MDR) 感染
1Department of Respiratory Medicine, Tongji Medical College, Liyuan Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Immunity, inflammation and disease
|July 18, 2024
概括
周围血液的指标,如高中性粒细胞与淋巴细胞的比率 (NLR) 和血小板数与淋巴细胞的比率 (PLR),可以表明老年患者的多药耐药细菌 (MDR) 感染. 这些发现有助于制定MDR感染的早期临床预防策略.
科学领域:
- 传染性疾病 传染性疾病
- 血液学 血液学 血液学
- 老年病的医生 老年病的医生
背景情况:
- 耐多药细菌 (MDR) 感染对住院的老年患者构成重大威胁.
- 早期发现MDR感染对于有效治疗和预防并发症至关重要.
- 外周血液指标为非侵入性早期检测提供了一个潜在的途径.
研究的目的:
- 确定外周血液指标,可以作为老年住院患者中MDR感染的早期预警信号.
- 在这个脆弱人群中提供针对MDR感染的临床预防策略的数据.
主要方法:
- 对721名老年住院患者的临床数据的回顾性分析,分为MDR感染者 (n=488) 和MDR未感染者 (n=233) 组.
- 单变量和多变量逻辑回归,以及Chi平方自动相互作用探测器 (CHAID) 决策树模型,用于分析风险因素和外周血液指标.
- 在p < 0.05.05时确定了统计学意义.
主要成果:
- 葡萄球菌 spp. 葡萄球菌 spp. 是最常见的MDR菌株 (148/488).
- 对MDR感染的独立风险因素包括长时间住院,入院前使用抗生素,抗生素治疗的持续时间,侵入性手术/手术和肺部疾病.
- 中性粒细胞与淋巴细胞比率 (NLR) 的升高,血小板数与淋巴细胞比率 (PLR),中性粒细胞和乙素细胞以及淋巴细胞的减少与MDR感染有关,特别是与抗生素使用和侵入性手术有关.
结论:
- 升高的NLR,PLR,中性粒细胞和乙氨基粒细胞,加上淋巴细胞的降低,可以作为老年住院患者中MDR感染的早期指标.
- 这些血液学标记可以为早期干预和预防MDR感染提供临床决策的信息.
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