| 孟兰,康冬梅,许美丽,等.糖尿病合并社区获得性肺炎患者发生血流感染的临床特点分析[J].中国临床保健杂志,2026,29(3):392-396. |
| 糖尿病合并社区获得性肺炎患者发生血流感染的临床特点分析 |
| The clinical characteristics of community-acquired pneumonia with bloodstream infection in patients with diabetes |
| 投稿时间：2025-12-03 |
| DOI：10.3969/J.issn.1672-6790.2026.03.019 |
| 中文关键词: 糖尿病 肺炎 社区获得性感染 机会致病菌感染 危险因素 |
| 英文关键词: Diabetes mellitus Pneumonia Community-acquired infections Opportunistic infections Risk factors Fund program:National Natural Science Foundation of China |
| 基金项目:国家自然科学基金项目 |
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| 中文摘要: |
| 目的 探讨糖尿病合并社区获得性肺炎患者发生血流感染时病原菌分布特点和危险因素分析。方法 采用回顾性研究。收集2020年6月至2024年12月中国科学技术大学附属第一医院(安徽省立医院)收治的61例糖尿病合并社区获得性肺炎患者的临床资料。按入院48 h内血培养结果分为血流感染组27例和非血流感染组34例。采用单因素/多因素logistic回归分析探讨血流感染组患者的发病危险因素。结果 27例血流感染者组患者共分离出27株病原菌,前三位分别为大肠埃希菌(8株,29.63%)、肺炎克雷伯菌(8株,29.63%)和人葡萄球菌(3株,11.11%)。临床资料分析发现,与非血流感染组相比,血流感染组中合并消化道出血(P=0.014)和合并酮症酸中毒(P=0.023)发病率更高,平均住院费用(P=0.042)更高,整体预后(P=0.021)更差,差异均有统计学意义(均P<0.05)。单因素回归分析显示,年龄、循环系统病史、神经系统病史、血肌酐、白蛋白和降钙素原(PCT)与糖尿病合并社区获得性肺炎患者发生血流感染有关(P<0.05)；多因素回归分析显示,血白蛋白和PCT是糖尿病合并社区获得性肺炎患者发生血流感染的独立危险因素(均P<0.05)。结论 糖尿病合并社区获得性肺炎患者发生血流感染以革兰氏阴性菌感染为主,最常见的致病菌为大肠埃希菌和肺炎克雷伯菌,血白蛋白和PCT是其发生血流感染的独立危险因素。 |
| 英文摘要: |
| Objective To investigate the pathogen distribution and risk factors analysis of community-acquired pneumonia with bloodstream infection in patients with diabetes.Methods A retrospective study was conducted.Sixty-one diabetics with community-acquired pneumonia admitted in the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) from June 2020 to December 2024 were divided into bloodstream infection (BSI) and no-bloodstream infection (NBSI) groups according to the results of blood culture.The onset risk factors of the BSI group were analyzed by univariate/multivariate logistic analysis.Results Twenty-seven strains of pathogens were isolated from the BSI groups,and the third most frequently pathogens were Escherichia coli (8 strains,29.63%),Klebsiella pneumoniae (8 strains,29.63%) and Staphylococcus (3 strains,11.11%).Compared with the NBSI group patients,the BSI group patients showed a higher rate of combined gastrointestinal bleeding (P=0.014) and combined ketoacidosis (P=0.023),the higher expenses for the average hospitalization (P=0.042) and a poorer recovery rate (P=0.021).Univariate logistic regression analysis showed that age,the history of circulation system diseases,the history of nervous system diseases,the serum Cr,the Alb and the PCT (procalcitonin) were associated with the onset of BSI in diabetic patients with community-acquired pneumonia.Multivariate logistic regression analysis showed that the Alb and PCT were the risk factors for the onset of BSI in diabetic patients with community-acquired pneumonia (both P<0.05).Conclusions Gram-negative bacteria are mainly infected in diabetic patients with community-acquired pneumonia who develop BSI,and Escherichia coli and Klebsiella pneumoniae are the main pathogens.The albumin and PCT are the risk factors for the onset of BSI in diabetic patients with community-acquired pneumonia. |
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