Related factors of multiple drug resistant infection in aged patients with hypostatic pneumonia:analysis of 622 cases
Received:September 22, 2018  Revised:October 18, 2018
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Key words:aged  hypostatic pneumonia  multiple drug resistant bacterium
Author NameAffiliationE-mail
XIE Zhao-Yun Department of Infection Control, 
LI Yao-Fu Department of Infection Control,  
XIONG Yun Department of Infection Control,  
MENG Gui-Luan Department of Infection Control,  
YANG Huai Department of Infection Control, Guizhou Provincial People′s Hospital, Guiyang 550002, China  
YANG Zhong-Ling Department of Clinical Laboratory, the Third Affiliated Hospital of Guizhou Medical University, Duyun 558000, China  
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      Objective To analyze the risk factors of multiple drug resistant bacteria (MDRB) infection in the elderly patients with hypostatic pneumonia in order to provide reference for clinical diagnosis and treatment. Methods A retrospective analysis was carried out on 622 elderly hospitalized patients with pendulous pneumonia admitted in the Third Affiliated Hospital of Guizhou Medical University from February 2012 to July 2018. According to whether the strains of MDRB were isolated from their clinical infection specimens, they were divided into MDRB group and non-MDRB group. SPSS statistics 20.0 was used to perform the statistical analysis. Chi-square test was employed for intergroup comparison. The risk factors of MDRB infection were analyzed with univariate and multivariate logistic regression analyses. Results The infection rate of MDRB was 34.43%(167/485). Univariate analysis showed that age (>70 years), history of chronic pulmonary infection, history of chronic cardio-cerebrovascular disease, history of diabetes mellitus, course of disease (>15 d), APACHE Ⅱ score >20, coma, smoking history, and time of antibiotic usage (>7 d), types of applied antibiotics (≥3) and blood glucose (≥11.1 mmol/L) were the risk factors of MDRB infection in the elderly (P<0.05). Semi-sitting position, aerosol inhalation and oral nursing were the protective factors of the infection (P<0.05). Logistic regression analysis presented that the history of chronic pulmonary infection (OR=3.472,5%CI 1.866-6.461; P=0.000) and combined use of antimicrobial agents (≥3) (OR=3.760,5%CI 1.775-7.968; P=0.038) were independent risk factors for MDRB infection. Aerosol inhalation (OR=0.624, 95%CI0.400-0.974;P=0.000) and oral care (OR=0.256,5%CI0.161-0.408; P=0.001) were the protective [JP+1]factors of MDRB infection in the aged patients with pendulous pneumonia. Conclusion MDRB infection in elderly patients with pendulous pneumonia is related to many factors. Clinical attention should be paid to these patients, and rational use of antimicrobial agents, oral care and comprehensive measures such as aerosol inhalation and sputum drainage can reduce the infection of MDRB.