Analysis Of Influencing Factors Of Pulmonary Infection With Multidrug-resistant Bacteria In Patients With Chronic Kidney Disease

Objective : To investigate the influencing factors of pulmonary infection caused by multidrug-resistant bacteria(MDROs)in patients with chronic kidney disease(CKD)in the department of nephrology of The First Affiliated Hospital of Wannan Medical College.Methods:Through the database of the Information Center of our hospital,a retrospective study was conducted to collect the information of patients with chronic kidney disease who were diagnosed with pulmonary infection and positive sputum culture results during hospitalization in the department of nephrology medicine from October 2010 to October2018.Patients with fungal infection,death,severe disease or incomplete information were excluded.Finally,a total of 678 strains of pathogenic bacteria were tested.The samples were separated into two groups based on the findings of the bacterial drug sensitivity test performed on the patient’s first sputum culture(multi-drug resistance group 296 strains and non-multi-drug resistance group 382 strains).At the same time,basic information such as gender and blood sample consequence such as white blood cell,neutral ratio,red blood cell volume,hemoglobin,albumin,creatinine,uric acid,electrolyte,and blood lipid were collected.Univariate analysis and multivariate logistic regression were used to analyze the risk factors associated with pulmonary infection in MDROs.Results : A total of 296 MDROs strains(43.7%)were found,with the top five being Pseudomonas aeruginosa(32.8%),Escherichia coli(18.6%),Klebsiella pneumoniae(15.2%),Enterobacter cloacae(9.1%),and Staphylococcus aureus(5.4%).Patients with an estimated glomerular filtration rate(e GFR)of < 90 ml/(min·1.73m2)were negatively associated with the risk of Mdros-associated infection with e GFR levels.History of deep vein catheters(OR=1.62,95%CI: 1.16-2.27,P=0.005)and history of dialysis(OR =1.72,95%CI: 1.17-2.54,P=0.006)were an independent risk factor for multidrug-resistant bacteria associated pulmonary infection in CKD patients.Conclusion:Pulmonary infections of multidrug-resistant bacteria in patients with chronic kidney disease were mostly Pseudomonas aeruginosa,Escherichia coli,Klebsiella pneumoniae,Enterobacter cloacae and Staphylococcus aureus.Among them,e GFR decline,MDROS-related pulmonary infection in CKD patients.