Analysis Of Of Etiology And Risk Factors Of Hospital-acquired Pneumonia In The Senile

Objectives:Hospital acquired pneumonia(HAP)is one of the most common nosocomial infection.About 70% of HAP patients are the elderly,especially among the patients ≥ 80 years old,and this proportion will be higher.This study focuses on the analysis of risk factors and etiology of HAP,with a view to reducing the incidence of HAP and providing some evidence for anti-infective therapies.Methods:The 117 senile HAP patients and 117 same pariod,same gender,same department,same age senile patients without HAP hospitalized in the Guanghzou first people’s hospital from January to December 2018 were collected.Through the electronic medical record system,the patient’s age,gender,hospitalization date,hospitalization number,basic disease,sputum culture,etc.were collected,and the risk factors,etiology distribution and drug resistance were analyzed.Outcomes:The average age of the senior HAP group and non-HAP group was(88.1±4.0)years old and(87.3±3.5)years old.There weren’t statistical differences in age and gender between HAP group and non-HAP group(P >0.05).In terms of underlying diseases,there are 51(43.6%)people with chronic obstructive pulmonary disease in the HAP group,26(22.2%)people in the non-HAP group;94(80.3%)people in the HAP group with cardiovascular disease,97(82.9%)people in the non-HAP group;97(82.9%)people in the HAP group with cerebrovascular disease,77(65.8%)people in the non-HAP group;42(35.9%)people in the HAP group with diabetes,38(32.5%)people in the non-HAP group.There were statistical differences in COPD and cerebrovascular diseases between HAP group and non-HAP group.In the analysis of risk factors,it was found that there are statistical differences in terms of disturbance of consciousness and abnormal mental state,use of sedative drugs,use of acid suppression drugs,tracheotomy,central venous catheters inserted,nasogastric tubes feeding,and long-term bed rest.Further logistics analysis found that COPD,long-term bed rest,use of acid suppression drugs,central venous catheters inserted,and nasogastric tubes feeding were independent risk factors for advanced HAP.In terms of etiology,all patients had sputum culture,HAP group isolated 21 strains of pathogenic bacteria by sputum culture and 13 strains of pathogenic bacteria by blood culture.In senile HAP patients,gram-negative bacilli(G-)are the main pathogenic bacteria(19 strains),the most common pathogenic bacteria are Pseudomonas aeruginosa(7 strains);Klebsiella pneumoniae(4 strain);Acinetobacter baumannii(3 strains);Escherichia coli(3 strains).The further drug resistance analysis shows that the common pathogens in the HAP group were generally multi-drug resistant and highly resistant to the common third-generation cephalosporin antibiotics;HAP group was highly sensitive to polymyxin,Amikacin.Conclusion:The independent risk factors for elderly HAP patients are COPD,long-term bed rest,use of acid suppression drugs,central venous catheters inserted,and nasogastric tubes feeding.Gram-negative bacteria(G-)are common pathogens in senile HAP patients,and the most common bacteria is Pseudomonas aeruginosa.Currently,the most HAP pathogens in senile patients are multi-drug resistant,but are highly sensitive to tigecycline(except Pseudomonas aeruginosa),polymyxin and Amikacin.