Correlation Analysis Of Risk Factors And Pathogenic Characteristics Of Patients With Maintenance Hemodialysis

Objectives: To collect the clinical data of patients admitted for maintenance hemodialysis(MHD)due to infection,analyze the clinical and laboratory indicators,risk factors,pathogenic bacteria spectrum,drug resistance,clinical efficacy and other data related to infection in MHD patients,in order to improve patients quality of life and reduce the incidence of infection.Methods: 1.Select the basic case data of 389 patients with end-stage renal disease who underwent maintenance hemodialysis in our hospital’s blood purification center from January 2013 to December 2019.They are divided into infection and non-infection group according to whether they have combined infection 2.Retrospective statistical analysis of the general situation of infected and non-infected groups(gender,dialysis age,smoking history,primary disease,etc.),cardio-cerebral vascular complications,dialysis data,laboratory indicators(hemoglobin(Hb),C-reactive protein(CRP),plasma albumin(Alb),white blood cells(WBC),neutrophil cell percentage(NE%),etc.),infection sites,types and distribution of pathogens,and drug treatment situation 3.T test,chi-square test,rank-sum test were used to compare the differences between the two groups of indicators,and logistic regression analysis was used to study the risk factors of the infection group.Results: A total of 389 patients met were included in the study,aged between 20 and 90 years,with an average age of 59.10 ± 13.17 years and an average dialysis age of 61.83 ± 45.94 months.The infection rate was 31.36%(122/389).Diabetic nephropathy was the biggest rate in the infection group 44(36.1%).Compared with the non-infected group,the number of patients in the infected group was different in age,combined diabetes,pleural effusion,cardiac insufficiency,length of hospital stay,white blood cells,neutrophil percentage,and type B natriuretic peptide.,C-reactive protein,hemoglobin,serum albumin,transferrin saturation,and dry weight were statistically significant(P <0.05).Multiple logistic regression analysis showed that age was the main risk factor for infection in patients with MHD,hemoglobin and Serum albumin is a protective factor.The main site of infection is pulmonary infection.Pulmonary infection combine urinary tract infection are highest in multiple infections.Patients with catheter-related infections are more likely to have bacteremia simultaneously.Gram-negative bacteria are highest in detected specimens,accounting for 48.39%(60 / 124).Gram-negative bacteria are the main infections of the lungs.Gram-negative bacteria are different from Gram-positive bacteria in different infection sites,and the difference has statistically significant.(P <0.001).Gram-negative bacteria were sensitive to imipenem,meropenem,amikacin,and cefepime(> 50%).Gram-positive bacteria were extremely sensitive to tigecycline and vancomycin(100%),highly resistant to penicillin-G,erythromycin,and levofloxacin.The initial antibacterial programs are mostly monotherapy,the most commonly used is β-lactams(41.67%),followed by is quinolone(22.73%).Conclusions: 1.The incidence of concurrent infection in MHD patients was 31.36%.The main primary disease in the infection group was diabetic nephropathy,which accounted for 36.1%.Older patients were more likely to be infected.2.The main infection site of MHD patients was lung,accounting for 48.8%,followed by urinary tract,bacteremia and catheter-related infections.The main pathogenic bacteria of lung infection were Gram-negative bacteria,and the main pathogenic bacteria of bacteremia was gram-positive bacteria.3.The main risk factors of concurrent infection in MHD patients are old age,anemia,and low serum albumin level.