Pathogenic bacteria of nosocomial infection after intervention in patients with acute myocardial infarction and construction of its risk factor model
OBJECTIVE To analyze the pathogenic bacteria of nosocomial infection after intervention in patients with acute myocardial infarction(AMI)and to construct and evaluate the constructed model of their risk factors.METHODS From Oct.2019 to Oct.2022,498 AMI patients treated by interventional therapy in Kaifeng People's Hospital were divided into nosocomial infection group(n=31)and non-nosocomial infection group(n=467)ac-cording to whether nosocomial infection occurred or not.The sites and pathogenic bacteria of nosocomial infection in patients with AMI after interventional therapy were analyzed,the risk factors of nosocomial infection in patients with AMI after interventional therapy were summarized and models were established.The predictive value of the risk factor model for nosocomial infection after interventional therapy in patients with AMI was analyzed by receiv-er operating characteristic curve(ROC)curve.RESULTS The main part of nosocomial infection in patients with AMI after interventional treatment was the lower respiratory tract,accounting for 51.61％.The incidence of noso-comial infection in 498 AMI patients after interventional therapy was 6.22％,of which 64.71％were gram-nega-tive bacteria,25.49％were gram-positive bacteria and 9.80％were fungi.Multivariate Logistic analysis showed that heart failure and hypoproteinemia were the risk factors for nosocomial infection in patients with AMI after in-terventional therapy(OR=1.898,1.719,P＜0.05).Elevated serum Hb level was a protective factor for nosoco-mial infection in patients with AMI after interventional therapy(OR=0.508,P＜0.05).The above indicators were included in the risk factor model:logit(P)=-12.489+0.641 × heart failure+0.542 × hypoproteine-mia-0.678× serum Hb level.When logit(P)＞6.85,the area under the curve(AUC)was 0.875,95％CI was 0.842-0.902,x2=13.165.The diagnostic sensitivity was 83.87％and the specificity was 80.30％.CONCLUSION Respiratory tract infection was the main cause of nosocomial infection after interventional therapy in patients with AMI,and gram-negative bacteria were the main pathogenic bacteria.Multiple factors were closely related to the occurrence of nosocomial infection in patients with AMI after interventional therapy,and the con-struction of risk factor model had a certain predictive value.
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