International Medicine and Health Guidance News ›› 2022, Vol. 28 ›› Issue (3): 406-410.DOI: 10.3760/cma.j.issn.1007-1245.2022.03.026

• Clinical Research • Previous Articles     Next Articles

Pathogen distribution and risk factors of pneumonia combined with diabetic foot infection

Liu Minhuan   

  1. Department of Internal Medicine, Shangqiu Municipal Hospital, Shangqiu 476000, China

  • Received:2021-07-12 Online:2022-02-01 Published:2022-03-01
  • Contact: Liu Minhuan,Email:dd7195513@163.com

肺炎合并糖尿病足感染的病原菌分布特征及危险因素分析

刘敏环   

  1. 商丘市立医院内科,商丘 476000
  • 通讯作者: 刘敏环,Email:dd7195513@163.com

Abstract: Objective To explore the distribution of pathogenic bacteria in patients with pneumonia and diabetic foot infection and analyze the related risk factors. Methods A total of 128 patients with pneumonia and diabetes admitted to Shangqiu Municipal Hospital from June 2017 to June 2020 were selected as the study objects. The 42 patients who had diabetic foot ulcer infection were set as an infected group, and the rest 86 patients who did not have infection were set as an uninfected group. The distribution characteristics of pathogenic bacteria in diabetic foot ulcer were analyzed, and the clinical data, such as age, gender, underlying diseases, and infection were collected. The measurement data were compared between these two groups by independent-sample t test, and the enumeration data by χ2 test. Single and multivariate logistic regression analyses were used to explore the relevant risk factors of pneumonia combined with diabetic foot infection. Results There were no statistical differences in gender, age, body mass index, smoking, and underlying diseases between these two groups (all P>0.05). There were 82 strains of pathogenic bacteria in the 42 patients with diabetic foot infection, including 34 strains (41.46%) of gram positive bacteria, 43 strains (52.43%) of gram-negative bacteria strains, and 5 strains (6.10%) of other bacteria. There were statistical differences in diabetic nephropathy, diabetic peripheral neuropathy, diabetic foot course, APCHE Ⅱ score, high density lipoprotein cholesterol (HDL-C), fibrinogen, white blood cell count, C-reactive protein (CRP), albumin, fasting blood-glucose (FBG), and glycosylated hemoglobin (HbAlc) between these two groups (all P<0.05). Multivariate analysis showed that diabetic peripheral neuropathy, longer diabetic foot course, higher APCHE Ⅱ score, lower HDL-C, and higher HbAlc were independent risk factors for diabetic foot infection (all P<0.05). Conclusions The main pathogens of diabetic foot infection are gram-positive and gram-negative bacteria. Diabetic peripheral neuropathy, disease course, APCHE Ⅱ score, HDL-C, and HbAlc levels are the risk factors inducing infection. Based on the independent risk factors, the reasonable and effective intervention and prevention should be done to reduce the incidence of diabetic foot infection and promote the patients' quality of life and recovery.

Key words: Pneumonia combined with diabetic foot, Infection, Pathogenic bacteria, Risk factors

摘要:

目的 回顾性分析肺炎合并糖尿病足感染的病原菌分布特征,并分析相关危险因素。方法 选取商丘市立医院20186月至202012月收治的128例肺炎合并糖尿病患者作为研究对象。其中发生糖尿病足部溃疡感染的42例患者作为感染组,未发生感染的86例患者作为未感染组。分析糖尿病足部溃疡病原菌分布特点,并收集患者临床资料如年龄、性别、基础疾病、感染情况等。计量资料组间比较采用独立样本t检验,计数资料组间比较采用χ2检验,采用单因素和多因素logistic回归分析探究糖尿病足感染发生的相关危险因素。结果 糖尿病足部溃疡感染患者42例,未感染患者86例,两组患者的性别、年龄、身体质量指数(BMI)、吸烟、基础疾病、糖尿病视网膜病变比较差异均无统计学意义(均P>0.05)。42例糖尿病足感染患者培养病原菌82株,其中革兰阳性菌34株(41.46%),革兰阴性菌43株(52.43%)及其他菌株5株(6.10%)。糖尿病足感染组患者糖尿病肾病、糖尿病周围神经病变、糖尿病足病程、急性生理学及慢性健康状况评分系统APACHE Ⅱ)评分、高密度脂蛋白胆固醇(HDL-C)、纤维蛋白原、白细胞计数、C反应蛋白(CRP)、白蛋白、空腹血糖(FBG)及糖化血红蛋白(HbAlc)水平与未感染组患者比较差异均有统计学意义(均P<0.05)。多因素分析显示,患者糖尿病周围神经病变、糖尿病足病程越长、APACHE Ⅱ评分越高、HDL-C越低、HbAlc越高均是患者发生糖尿病足感染的独立危险因素(均 P<0.05)。结论 肺炎合并糖尿病足感染病原菌分布以革兰阳性和革兰阴性菌为主,糖尿病周围神经病变、病程、APACHE Ⅱ评分、HDL-CHbAlc水平均是诱导感染发生的危险因素,针对上述独立危险因素进行合理有效的干预和预防,降低糖尿病足感染的发生率,促进患者生活质量,早日康复。

关键词: 肺炎合并糖尿病足, 感染, 病原菌, 危险因素