Pathogens causing pulmonary infection and their risk factors in patients with initially treated pulmonary tuberculosis and the diagnostic efficacy of systemic inflammatory response index
10.11816/cn.ni.2025-241802
- VernacularTitle:初治肺结核患者合并肺部感染病原菌和危险因素及全身炎症反应指数的诊断效能
- Author:
Li LOU
1
;
Renfeng XIE
1
;
Aichun TAN
1
Author Information
1. 长沙市中心医院检验科,湖南长沙 410004
- Publication Type:Journal Article
- Keywords:
Initially treated pulmonary tuberculosis;
Pulmonary infection;
Pathogen;
Risk factor;
Systemic in-flammatory response index
- From:
Chinese Journal of Nosocomiology
2025;35(11):1628-1632
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To investigate the pathogens of pulmonary infection and their influencing factors in patients with initially treated pulmonary tuberculosis(PTB),and to analyze the diagnostic efficacy of systemic inflamma-tory response index(SIRI)for pulmonary infection.METHODS The clinical data of 459 patients with initially trea-ted PTB admitted to Changsha Central Hospital from Jan.to Dec.2023 were retrospectively analyzed,and they were divided into the combined group(n=90)and the non-combined group(n=369)according to the combina-tion of other pulmonary infections at the time of consultation.The pathogens of pulmonary infection,as well as the levels of monocytes(MN),neutrophils(NE),and lymphocytes(LYM),were analyzed,and the SIRI was calculated.The risk factors of pulmonary infection in initially treated PTB patients were explored by multivariate logistic regression analysis,and the diagnostic value of SIRI for pulmonary infection in initially treated PTB pa-tients was evaluated by receiver operating characteristic(ROC)curve.RESULTS The rate of pulmonary infection in 459 initially treated PTB patients was 19.61％(90/459),and a total of 103 pathogens were detected,of which 64 strains of gram-negative bacteria accounted for 62.14％,followed by 28 strains of gram-positive bacteria ac-counting for 27.18％,and 11 strains of fungi accounting for 10.68％,with Pseudomonas aeruginosa,Klebsiella pneumoniae and Staphylococcus aureus being predominant.Age(OR=1.908,95％CI:1.375-2.647),comor-bid diabetes(OR=2.073,95％CI:1.462-2.938),pulmonary cavities(OR=2.323,95％CI:1.588-3.398),delayed medical treatment(OR=2.024,95％CI:1.467-2.791)and elevated SIRI(OR=2.855,95％CI:1.851-4.402)were risk factors for pulmonary infection in initially treated PTB patients(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of SIRI for diagnosing pulmonary infection in initially treated PTB cases was 0.876(0.824-0.928),with a cut-off value of 4.96×109/L,a specificity of 85.91％,and a sen-sitivity of 86.67％.CONCLUSIONS The main pathogens in patients with initially treated PTB complicated with pulmonary infection are Pseudomonas aeruginosa and Klebsiella pneumoniae.Age,comorbid diabetes mellitus,pulmonary cavity,delayed medical treatment and elevated SIRI are all influencing factors for pulmonary infection in patients with initially treated PTB,and monitoring of SIRI can to some extent assist in diagnosis of whether pa-tients with initial treatment PTB are complicated with other pulmonary infections.
