大环内酯耐药卡他莫拉菌肺炎的危险因素及临床特征

蒋艳 王静 秦天 连星星 汤睿智 卢忠心 徐建国

蒋艳, 王静, 秦天, 连星星, 汤睿智, 卢忠心, 徐建国. 大环内酯耐药卡他莫拉菌肺炎的危险因素及临床特征[J]. 疾病监测, 2022, 37(5): 635-640. doi: 10.3784/jbjc.202111230604
引用本文: 蒋艳, 王静, 秦天, 连星星, 汤睿智, 卢忠心, 徐建国. 大环内酯耐药卡他莫拉菌肺炎的危险因素及临床特征[J]. 疾病监测, 2022, 37(5): 635-640. doi: 10.3784/jbjc.202111230604
Jiang Yan, Wang Jing, Qin Tian, Lian Xingxing, Tang Ruizhi, Lu Zhongxin, Xu Jianguo. Risk factors and clinical characteristics of macrolide resistance Moraxella catarrhalis pneumonia[J]. Disease Surveillance, 2022, 37(5): 635-640. doi: 10.3784/jbjc.202111230604
Citation: Jiang Yan, Wang Jing, Qin Tian, Lian Xingxing, Tang Ruizhi, Lu Zhongxin, Xu Jianguo. Risk factors and clinical characteristics of macrolide resistance Moraxella catarrhalis pneumonia[J]. Disease Surveillance, 2022, 37(5): 635-640. doi: 10.3784/jbjc.202111230604

大环内酯耐药卡他莫拉菌肺炎的危险因素及临床特征

doi: 10.3784/jbjc.202111230604
详细信息
    作者简介:

    蒋艳,女,江苏省无锡市人,硕士研究生,主要从事流行病与卫生统计学研究,Email:jiangyan@njmu.edu.cn

    通讯作者:

    卢忠心,Tel:027–82211234,Email:lzx71@yahoo.com

    徐建国,Tel:010–58900701,Email:xujianguo@icdc.cn

  • 中图分类号: R211; R183

Risk factors and clinical characteristics of macrolide resistance Moraxella catarrhalis pneumonia

More Information
  • 摘要:   目的  了解大环内酯耐药卡他莫拉菌(MRMC)肺炎患者的临床特征,探讨其患病的危险因素。  方法  对2013年1月至2022年1月的32例MRMC肺炎患者和114例大环内酯敏感卡他莫拉菌(MSMC)肺炎患者信息进行回顾分析。  结果  卡他莫拉菌肺炎患者以男性为主(71.92%),≥65岁者居多(67.12%),冬春季高发(64.38%)。 多因素logistic回归分析结果显示,女性(OR=2.77, 95%CI: 1.18~6.47)和陈旧性肺结核病史(OR=5.95, 95%CI: 1.31~31.57)是感染MRMC肺炎的独立危险因素。 MRMC组患者发热(OR=2.87, 95%CI: 1.09~7.46)、C反应蛋白升高(OR=2.65, 95%CI: 1.12~6.63)、支气管炎(OR=4.00, 95%CI: 1.54~11.52)和肺气肿影像学表现(OR=5.73, 95%CI: 1.94~19.56)的比例显著高于MSMC组。  结论  女性和陈旧性肺结核病史是感染MRMC肺炎的独立危险因素,且MRMC组患者的症状、炎症和影像学表现更严重,应关注其临床诊治。
  • 表  1  146例卡他莫拉菌肺炎患者的基本信息

    Table  1.   Basic information of 146 patients with Moraxella catarrhalis pneumonia

     变量例数构成比(%)
    性别
     男性10571.92
     女性4128.08
    年龄组(岁)
     <654832.88
     ≥659867.12
    吸烟
     是5235.62
     否9464.38
    饮酒
     是2013.70
     否12686.30
    季节
     冬春9464.38
     夏秋5235.62
    标本类型
     痰液13391.10
     支气管肺泡灌洗液13 8.90
    下载: 导出CSV

    表  2  大环内酯耐药卡他莫拉菌肺炎患者危险因素的单因素分析

    Table  2.   Univariate analysis on risk factors in patients with macrolides resistant Moraxella catarrhalis pneumonia

      变量大环内酯耐药卡他莫拉菌组(n=32)大环内酯敏感卡他莫拉菌组(n=114)χ 2P
    病例数(例)构成比(%) 病例数(例)构成比(%)
    性别(女)1546.882622.816.0240.014 a
    吸烟(是)618.754640.354.1860.041 a
    饮酒(是)26.251815.790.246 b
    基础疾病
    慢性阻塞性肺疾病1134.383026.320.4540.500
    陈旧性肺结核515.6332.630.013 ab
    高血压1650.006859.650.5980.439
    糖尿病825.002118.420.3290.566
    脑卒中后遗症1237.504135.96<0.0011.000
    冠状动脉粥样硬化性心脏病1237.503631.580.1740.677
    注:a. P<0.100,纳入多因素logistic回归分析;b. 采用Fisher确切概率法
    下载: 导出CSV

    表  3  大环内酯耐药卡他莫拉菌肺炎患者危险因素的logistic回归分析

    Table  3.   Logistic regression analysis on risk factors in patients with macrolides resistant Moraxella catarrhalis pneumonia

      变量变量赋值单因素logistic回归多因素logistic回归
    OR值(95%CIOR值(95%CIaOR值(95%CIb
    性别男=0,女=12.99(1.31~6.83)c2.77 (1.18~6.47)c
    吸烟否=0,是=10.34(0.12~0.85)c0.55 (0.17~1.60)
    陈旧性肺结核否=0,是=1 6.85(1.58~35.10)c 9.65 (1.97~56.53)c 5.95 (1.31~31.57)c
    注:a. 调整年龄和性别因素;b. 逐步回归法筛选后,纳入性别和陈旧性肺结核因素后的多因素logistic回归分析结果;c. OR值对应的P<0.050,差异有统计学意义;–. 未纳入多因素logistic回归分析
    下载: 导出CSV

    表  4  大环内酯耐药卡他莫拉菌肺炎患者临床特征的单因素分析

    Table  4.   Univariate analysis on clinical characteristics of patients with macrolides resistant Moraxella catarrhalis pneumonia

      变量大环内酯耐药卡他莫拉菌组(n=32)大环内酯敏感卡他莫拉菌组(n=114)wχ2 P
    病例数或
    中位数
    构成比(%)或
    Q1~Q3
    病例数或
    中位数
    构成比(%)或
    Q1~Q3
    临床表现a
     咳嗽2268.758171.050.0010.974
     咳痰1856.256859.650.0200.887
     发热1031.251815.792.9200.087c
     咯血39.3821.750.070 ce
     喘息气促1340.634236.840.0340.854
    感染指标(n=137)a30107
     白细胞计数(>9.5×109 /L)1240.003028.041.0650.302
     C反应蛋白(>0.6 mg/mL)2066.674441.125.1590.023 c
     降钙素原(>0.5 ng/mL)310.001614.950.765 e
    影像学表现(n=122)a2993
     支气管炎1965.523941.944.0290.045 c
     肺气肿1344.832324.733.3800.066 c
     肺结节931.032627.960.0070.932
     胸腔积液931.033133.33<0.0010.997
     肺间质性病变827.591819.350.4700.493
    疾病危险程度
     住院天数(d)b116~18129~222171.50.100
     抗生素使用种类(种)b21~411~21391.50.034 c
     抗生素使用天数(d)b63~833~61544.00.166
     是否入住ICU(是)a1031.253127.190.0520.819
     是否气管插管(是)a412.5076.140.258 e
     CURB-65评分(分)b10~211~217570.742
     qSOFA评分(分)b00~100~11655.50.316
     是否住院期间死亡(是)a00.0032.631.000e
    注:a.为计数资料,分析采用病例数和构成比;b.为计量资料,分析采用中位数和分位数;c. P < 0.100,纳入多因素logistic回归分析;
    e. 采用Fisher确切概率法;Q1为25%分位数,Q3为75%分位数;CURB-65评分为英国胸科协会改良肺炎评分;qSOFA评分为快速序贯器官衰竭评分
    下载: 导出CSV

    表  5  大环内酯耐药卡他莫拉菌肺炎患者临床特征的logistic回归分析

    Table  5.   Logistic regression analysis on clinical characteristics of patients with macrolides resistant Moraxella catarrhalis pneumonia

      变量变量赋值单因素logistic回归多因素logistic回归
    OR值 (95%CIOR (95%CI a
    发热否=0,是=12.42 (0.96~5.92)2.87 (1.09~7.46) b
    咯血否=0,是=15.79 (0.92~45.55)5.91 (0.87~48.86)
    C反应蛋白≤0.6 mg/mL=0,>0.6 mg/mL=12.86 (1.25~6.94) b2.65 (1.12~6.63) b
    支气管炎否=0,是=12.63 (1.12~6.48) b4.00 (1.54~11.52) b
    肺气肿否=0,是=12.47 (1.03~5.93) b5.73 (1.94~19.56) b
    抗生素使用种类≤3种=0,>3种=12.80 (1.05~7.20) b2.57 (0.91~7.04)
    注:a.调整年龄和性别因素;b. OR值对应的P<0.050,差异有统计学意义
    下载: 导出CSV
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  • 收稿日期:  2021-11-23
  • 网络出版日期:  2022-04-21
  • 刊出日期:  2022-05-31

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