Clinical characteristics of puerperal infection complicated by gestational diabetes mellitus and its relationship with coagulation abnormalities
Objective To investigate the clinical characteristics of puerperal infections complicated by gestational diabetes mellitus(GMD),the resistance of pathogenic bacteria,and their relationship with coagulation abnormalities.Methods A retrospective study was conducted from August 2021 to August 2024 on 698 cases of GMD women who underwent labor and delivery examination in our hospital,and they were divided into infected group(n=42 cases)and uninfected group(n=656 cases)according to the occurrence of puerperal infections.We analyzed the clinical characteristics of GMD complicated puerperal infections and drug resistance of pathogenic bacteria;compared the general information and coagulation indexes of the infected group and the uninfected group;analyzed the influencing factors of GMD complicated puerperal infections by binary logistic regression model;and analyzed the value of coagulation function in predicting GMD complicated puerperal infections by ROC curve.Results The main sites of puerperal infections in 42 cases were genital tract infections(45.24％),intrauterine infections(23.81％),and respiratory infections(19.02％).68 strains of pathogenic bacteria were detected in the 42 women with puerperal infections,including 36 strains of Gram-positive bacteria(85.71％),36 strains of Gram-negative bacteria(64.29％),and 5 strains of fungi(11.90％),and the main pathogens of Gram-positive bacteria were Aurelia,Aurelia,and Aurelia.The main pathogens of the positive bacteria were Staphylococcus aureus and Staphylococcus epidermidis;the main pathogens of the gram-negative bacteria were Escherichia coli and Pseudomonas aeruginosa.The major Gram-positive bacteria(Staphylococcus aureus,Staphylococcus epidermidis)were highly resistant(＞50.0％)to ofloxacin,ciprofloxacin,cefotaxime,cefradine,and ampicillin,and the major Gram-negative bacteria(Escherichia coli,Pseudomonas aeruginosa)were highly resistant(＞50.0％)to imipenem,ceftazidime,piperacillin/tazobactam,gentamicin,and ampicillin.Binary logistic regression model showed that the combination of gestational hypertension,full-term delivery,postpartum hemorrhage,uncontrolled blood glucose,premature rupture of membranes,PT level,FIB level,and ATⅢ level were all influential factors for GMD-complicated puerperal infections(P＜0.05).The ROC curve analysis showed that the AUCs for the prediction of GMD-complicated puerperal infections by PT level,FIB level,and ATⅢ level The AUC of the combined model of coagulation indexes for predicting GMD complicating puerperal infection was 0.899,with a sensitivity and specificity of 78.6％and 84.3％,respectively.Conclusion The pathogens of GMD complicated puerperal infections were mainly gram-positive bacteria with good drug resistance,and the combination of gestational hypertension,full-term delivery,postpartum hemorrhage,uncontrolled blood glucose,premature rupture of membranes,PT level,FIB level,and AT Ⅲ level were the influencing factors of GMD complicated puerperal infections;and the combined model of coagulation indexes was of good value in the prediction of GMD complicated puerperal infections.Infections in the peripartum period.
NETL
NSTL
万方数据
