Analysis of pathogenic bacteria distribution,drug resistance and influencing factors in elderly pulmonary tuberculosis complicated with pneumonia
Objective To analyze the pathogenic bacteria distribution,drug resistance and influencing fac-tors in elderly patients with pulmonary tuberculosis complicated with pneumonia.Methods The clinical data of 270 elderly pulmonary tuberculosis patients admitted to the Third Hospital of Cangzhou City from June 2020 to December 2022 were retrospectively analyzed,and the distribution and drug resistance of pathogenic bacteria in sputum samples of patients were analyzed.They were divided into the combined group and the non-combined group according to whether they were combined with pneumonia or not,and compared the clinical data of the two groups.Multivariate Logistic regression was used to analyze the influencing factors of elderly patients with pulmonary tuberculosis complicated with pneumonia.Results Among 270 elderly patients with pulmonary tuberculosis,65 patients with pneumonia were included in the combined group,and the remaining 205 patients without pneumonia were included in the non-combined group.A total of 72 strains were isolated from 65 sputum samples of patients in the combined group,45 strains of gram-negative bacteria,accounting for 62.50％,mainly Klebsiella pneumoniae and Pseudomonas aeruginosa.There were 22 strains of gram-posi-tive bacteria,accounting for 30.56％,mainly Staphylococcus aureus and Staphylococcus haemolyticus.There were 5 strains of fungi,accounting for 6.94％.In the combined group,Klebsiella pneumoniae had higher re-sistance rate to ampicillin and cefazolin.Pseudomonas aeruginosa had high resistance rate to co-sulfamethox-azole,ampicillin and ampicillin/sulbactam.Staphylococcus aureus had high resistance rate to penicillin and e-rythromycin.Staphylococcus haemolyticus had high resistance rate to erythromycin,penicillin and azithromy-cin.The proportions of patients with invasive operation,long-term use of glucocorticoids,and long-term use of broad-spectrum antibiotics in the combined group were higher than those in the non-combined group,the number of Bifidobacterium was lower than that in the non-combined group,and the number of Escherichia coli and Enterobacterium was higher than that in the non-combined group,with statistical significance(P＜0.05).Multivariate Logistic regression analysis showed that invasive operation,long-term use of glucocorticoids,long-term use of broad-spectrum antibiotics,decrease in Bifidobacterium number and increase in Enterobacte-rium number were risk factors for the occurrence of combined pneumonias of pulmonary tuberculosis in the elderly(P＜0.05).Conclusion The main pathogens in sputum samples of elderly patients with pulmonary tuberculosis complicated with pneumonia are gram-negative bacteria,and there are significant differences in drug resistance among different pathogens.Intestinal flora disturbance,advanced age,long-term use of glu-cocorticoids and broad-spectrum antibiotics may increase the risk of pulmonary tuberculosis complicated with pneumonia in the elderly.
万方数据
维普
