Search

Copyright of Journal of Modern Laboratory Medicine is the property of Journal of Modern Laboratory Medicine Editorial Department and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To observe the pathogenic bacteria distribution characteristics in postoperative pulmonary infection in patients with lung cancer, and to analyze the influencing factors of infection. From March 2018 to December 2020, the clinical datas of patients with lung cancer (n=358) who were treated in our hospital were analyzed. The number of postoperative pulmonary infection in patients with lung cancer was counted, and they were divided into infected group and uninfected group according to this. The pathogenic bacteria distribution characteristics were observed, and the risk factors of infection were discussed. Among 358 patients with lung cancer, 32 patients developed postoperative pulmonary infection, with an infection rate of 8.94%. 49 s of pathogenic bacteria were isolated from 32 cases of postoperative pulmonary infection in patients with lung cancer, including 31 strains of Gram-negative bacteria, accounting for 63.27%. 15 strains of gram-positive bacteria accounted for 30.61%. 3 strains of fungi, accounting for 6.12%. The top five were Klebsiella pneumoniae with 24.49%, Enterobacter clovis with 14.29%, Staphylococcus aureus with 12.24%, Pseudomonas aeruginosa with 10.20% and A cinetobacter baumannii with 10.20%. Univariate and multivariate logistic regression analysis showed that postoperative pulmonary infection was associated with long-term smoking history, operation method, incision pain score, chronic obstructive pulmonary disease history, age, operation time and diabetes mellitus history ( P<0.05). The risk factors of postoperative pulmonary infection in patients with lung cancer included chronic obstructive pulmonary disease history, incision pain score 4~6 scores, long-term smoking history, diabetes mellitus history, age ≥ 60 years, the operation method was routine operation, operation time ≥ 3 h (P<0.05). Incision pain score, long-term smoking history, chronic obstructive pulmonary disease history, age, operation time, diabetes mellitus history, and operation method are all risk factors for postoperative pulmonary infection in patients with lung cancer, and active measures can be taken to deal with these factors, gram-negative bacteria are the main pathogens of postoperative pulmonary infection in patients with lung cancer, and reasonable preventive antibiotics should be given for clinical treatment. [ABSTRACT FROM AUTHOR]

Objective: To investigate the pathogenic bacteria composition, drug resistance characteristics and death influencing factors of patients with acute respiratory distress syndrome (ARDS) complicated with pulmonary infection. Methods: From January 2017 to January 2020, 98 patients with ARDS complicated with pulmonary infection who were treated in our hospital were included in this study. Sputum isolation and culture were carried out for all patients, and drug sensitivity test was carried out for pathogenic bacteria obtained from the separation. In addition, the number of patients who died within 28 days after admission was counted, univariate and multivariate Logistic regression analysis of influencing factors of death in patients with ARDS complicated with pulmonary infection. Results: A total of 163 strains of pathogenic bacteria were detected in 98 patients with ARDS complicated with pulmonary infection, from high to low, 123 strains of Gram-negative bacteria accounted for 75.46%, 33 strains of Gram-positive bacteria accounted for 20.25%, and 7 strains of fungus accounted for 4.29%. Among them, Gram-negative bacteria were mainly Pseudomonas aeruginosa (50 strains, accounting for 30.67%), A cinetobacter baumannii (32 strains, accounting for 19.63%) and Klebsiella pneumoniae (21 strains, accounting for 12.88% ). Pseudomonas aeruginosa, A cinetobacter baumannii, Staphylococcus aureus and hemolytic Staphylococcus had different degrees of resistance to common antibiotics, while Klebsiella pneumoniae had 0.00% resistance to Cefoperazone/sulbactam, cefepime, piperacillin/tazobactam and levofloxacin. Multivariate Logistic regression analysis showed that age ≥ 60 years, elevated C-reactive protein (CRP) and procalcitonin (PCT) levels, Acute physiological Function and Chronic health status scoring system Ⅱ (APACHE Ⅱ) score ≥ 25 scores, oxygenation index < 80 mmHg, length of Medical Intensive Care Unit (MICU) stay ≥ 10 d and mechanical ventilation time ≥ 6 d were all risk factors for death in patients with ARDS complicated with pulmonary infection (all OR>1, P<0.05). Conclusions: The pathogenic bacteria of patients with ARDS complicated with pulmonary infection are mainly Gram-negative bacteria, among which, Klebsiella pneumoniae has good sensitivity to Cefoperazone /sulbactam, cefepime, piperacillin/tazobactam and levofloxacin. Age, CRP, PCT level, APACHE Ⅱ score, oxygenation index, length of MICU stay and mechanical ventilation time are the influencing factors for the death of these patients. [ABSTRACT FROM AUTHOR]

Objective: To explore the clinical significance of the pathogen distribution, drug resistance analysis and serum inflammatory factor detection in patients with lung cancer complicated with pulmonary infection. Methods: From June 2018 to March 2020, 120 patients with lung cancer complicated with pulmonary infection in our hospital were selected as the infection group, 100 patients without lung cancer and pulmonary infection in our hospital as the lung cancer group, and 60 healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group. The types of infection pathogens of lung cancer complicated with pulmonary infection patients were summarized and analyzed, the drug susceptibility test results of common pathogenic bacteria were analyzed, and the drug resistance rate of pathogenic bacteria was calculated. Inflammatory factors were compared in the three groups. Results: A total of 100 strains of pathogenic bacteria were detected in the sputum samples of 90 patients with lung cancer complicated with pulmonary infection. Among the 100 strains of pathogenic bacteria, gram-negative bacteria dominated, followed by gram-positive bacteria and fungi, accounting for 63.00%, 22.00% and 15.00%, respectively. Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa had lower drug resistance to imipenem, and higher drug resistance to ampicillin and trimethoprim. Coagulase-negative Staphylococcus and Staphylococcus aureus showed higher resistance to vancomycin and lower resistance to levofloxacin. The drug resistance rates of Candida albicans and Tropical candida to amphotericin B, fluconazole, ketoconazole and itraconazole were all low. The levels of interleukin-6(IL-6), calcitonin(PCT) and tumor necrosis factor-α(TNF-α) in the infection group and lung cancer group were all higher than those in the control group, and the levels of these indicators in the infection group were higher than those in the lung cancer group (P<0.05). Conclusion: There are many kinds of pathogenic bacteria in patients with lung cancer complicated with pulmonary infection, and there are differences in drug resistance to common antimicrobial agents, and there are strong inflammatory reactions in patients, so antimicrobial agents should be rationally applied in clinical practice according to drug sensitivity results. [ABSTRACT FROM AUTHOR]

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To analyze the distribution and risk factors of pathogenic bacteria in liver cirrhosis complicated with pulmonary infection. Methods: 518 patients with liver cirrhosis who were treated in our Hospital from February 2013 to June 2018 were selected. The number of pulmonary infection in all patients was counted. The clinical data of the patients were collected,including gender, age, etiology, length of stay, with or without invasive operations, with or without ascites, Child-Pugh classification,with or without upper gastrointestinal bleeding and with or without the combination of basic diseases. The relationship between pulmonary infection and clinical data was analyzed, the distribution of pathogenic bacteria in patients with liver cirrhosis complicated with pulmonary infection was also detected, and multivariate logistic regression analysis was used to analyze the risk factors of pulmonary infection in patients with liver cirrhosis. Results: Among 518 patients with liver cirrhosis, 80 cases had pulmonary infection,the incidence rate was 15.44%. Univariate analysis showed that gender was not associated with lung infection in patients with cirrhosis (P>0.05). Age, etiology, length of stay, invasive operations, ascites, Child-Pugh classification, upper gastrointestinal bleeding and combined basic diseases were all the factors affecting the pulmonary infection in the patients with liver cirrhosis (P<0.05). Multivariate logistic regression analysis showed that age ≥60 years old, length of stay ≥2 weeks, with invasive operations and ascites, Child-Pugh classification with C grade, with upper gastrointestinal bleeding and combined basic disease were all risk factors for pulmonary infection in patients with liver cirrhosis (P<0.05). A total of 93 strains of pathogenic bacteria were detected in sputum samples from 80 patients with liver cirrhosis and pulmonary infection, including gram-negative bacteria with 51 strains, accounting for 54.84%,gram-positive bacteria with 37 strains, accounting for 39.78%, and fungi with 5 strains, accounting for 5.38%. Conclusion: The main pathogenic bacteria of liver cirrhosis complicated with pulmonary infection are Gram-positive bacteria and Gram-negative bacteria, and there are more risk factors for pulmonary infection. In clinically, corresponding preventive measures should be taken according to their risk factors to reduce the occurrence of pulmonary infection. [ABSTRACT FROM AUTHOR]

To analyze the distribution of multidrug-resistant bacteria in patients with acute myocardial infarction complicated with pulmonary infection and the relationship between inflammatory factors and myocardial enzymes. 67 patients with acute myocardial infarction complicated with pulmonary infection who were admitted to 940 Hospital of PLA Joint Logistics Support Force from February 2015 to October 2018 were selected as infection group, and 60 patients with simple myocardial infarction who were admitted in the same period were selected as uninfection group. The distribution and drug resistance of multidrug-resistant bacteria in infection group were analyzed. The levels of inflammatory factors and myocardial enzymes were compared between the two groups. Pearson correlation was used to analyze the correlation between inflammatory factors and myocardial enzymes in patients with infection group. A total of 136 pathogenic bacteria were isolated from sputum culture specimens of 67 patients. Among them, 64 strains belong to multi-drug resistant bacteria, 38 strains of Gram-negative bacteria account for 59.37%, 26 strains of Gram-positive bacteria account for 40.63%. Gram-negative bacteria were more sensitive to piperacillin/sulbactam, cefoperazone/sulbactam, amikacin, meropenem and imipenem. Gram-positive bacteria were sensitive to teicoplanin, vancomycin and rifampicin. The levels of interleukin-6 (IL-6), lactate dehydrogenase (LDH), angiopoietin-2 (Ang-2), creatine kinase (CK), tumor necrosis factor-琢(TNF-琢), aspartate aminotransferase (AST), creatine kinase isoenzyme (CKMB) in the infected group were higher than those in the uninfected group (P< 0.05). According to Pearson correlation analysis, the serum levels of IL-6, Ang-2 and TNF-琢were positively correlated with the levels of AST, LDH, CK and CK-MB (P<0.05). Myocardial enzymes of patients with acute myocardial infarction complicated with pulmonary infection is closely related to the level of inflammatory factors, which is helpful to judge the severity of patients'condition. Meanwhile, multidrug resistance in patients with acute myocardial infarction complicated with pulmonary infection is more serious, and antibiotics should be reasonably selected according to pathogenic bacteria in clinic. [ABSTRACT FROM AUTHOR]

BACKGROUND: The degenerative changes of heart disease in the elderly and the decrease of immune function of the body make the elderly patients with heart failure vulnerable to the infection of pathogenic bacteria. Tanreqing injection, a traditional Chinese compound medicine, has the functions of clearing heat, eliminating phlegm and detoxifying, and can be used to treat pulmonary infection. OBJECTIVE: To hypothesize that Tanreqing injection combined with ambroxol hydrochloride, a mucolytic drug, can effectively alleviate pulmonary infection and improve cardiac function in elderly patients with heart failure and pulmonary infection caused by degenerative heart disease. METHODS: This prospective, single-center, parallel, randomized, controlled clinical trial will include 320 patients with heart failure combined with pulmonary infection induced by senile degenerative heart disease from Sanya People’s Hospital, Sanya, China. All patients will receive conventional anti-heart failure treatment, and will be equally and randomly divided into a control group and a trial group. The patients in the control group will be treated with intravenous infusion of ambroxol hydrochloride. The patients in the trial group will be treated with intravenous infusion of ambroxol hydrochloride and Tanreqing injection. The treatment will be lasted for 7 days. Patient recruitment and data collection will begin on July 1, 2019 and end on August 30, 2021. Analysis of the results will be performed from September 10 to 30, 2021. This study will be scheduled to end on December 30, 2021. This study was approved by the Medical Ethics Committee of Sanya People’s Hospital in October 2015 (approval No. S2015-065-03). This study will be performed in strict accordance with the Declaration of Helsinki formulated by the World Medical Association. Written informed consent regarding the study protocol and surgery procedure will be obtained from the participants’ family members or the participants themselves. RESULTS AND CONCLUSION: (1) The primary outcome measure is total effective rate 7 days after treatment. (2) The secondary outcome measures are left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left ventricular ejection fraction, left ventricular fractional shortening, number of pathogenic bacteria in the lung, serum procalcitonin and C-reactive protein level changes before and 7 days after treatment, as well as incidence of adverse reactions 7 days after treatment. (3) Our pilot study involved 120 patients with senile heart failure from May 2016 to October 2017. These patients were randomly assigned to trial and control groups (n=60 per group). The results showed that Gram-positive bacteria were the main pathogens of pulmonary infection in senile patients with heart failure. The positive rate of Gram-positive bacteria was 53.7% in both control and trial groups. After treatment, the number of pathogenic bacteria in the trial group was remarkably lower than that in the control group (control group: trial group=17 strains: 11 strains). Compared with that before treatment, left ventricular end-diastolic diameter, left ventricular end-systolic diameter and left ventricular ejection fraction were significantly lower (P < 0.05), but left ventricular fractional shortening was significantly higher (P < 0.05), and serum procalcitonin and C-reactive protein levels were significantly decreased (P < 0.05) in both trial and control groups after treatment. Moreover, the changes of the above indicators were more significant in the trial group than in the control group (P < 0.05). (4) The results of the present study will confirm that Tanreqing injection combined with ambroxol hydrochloride can noticeably improve the cardiac function of senile patients with heart failure, and can obviously mitigate pulmonary infection caused by pathogenic bacteria. This study will identify adverse drug reactions due to degenerative heart disease. This study was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR1900022879) on April 29, 2019. Protocol version: 1.0. Results will be disseminated through presentations at scientific meetings and/or by publication in a peer-reviewed journal. [ABSTRACT FROM AUTHOR]

Objective: To investigate the pathogenic bacteria distribution and risk factors of pulmonary infection after tracheotomy in patients with stroke coma, and to put forward preventive measures. Methods: 96 patients with stroke coma from January 2016 to February 2017 in our hospital were retrospectively analyzed. The incidence of pulmonary infection and distribution of pathogenic bacteria of patients with stroke coma were analyzed. At the same time,the risk factors of pulmonary infection were analyzed by single factor and multiple factors logistic regression analysis, and corresponding preventive measures were put forward. Results: The incidence of pulmonary infection after tracheotomy in 96 patients with stroke coma was 48.96％ (47/96). A total of 104 pathogens were isolated and cultured, including gram negative bacteria 69 strains (66.35％), gram positive bacteria 20 strains (19.23％) and fungus 15 strains (14.42％). Single factor regression analysis results showed that pulmonary infection after tracheotomy in patients with stroke coma was closely related with age, basic diseases,time of tracheotomy, and bed time, use of broad-spectrum antibiotics, smoking history, artificial airway, times of sputum suction and inhalation(P＜0.05), and it was not related to the patient's gender, weight, stroke type (P＞0.05). Multivariate logistic regression analysis showed that age 45 years old, complicated with basic disease, time of tracheotomy 5 d, use of broad-spectrum antibiotics, smoking history and the establishment of artificial airway were risk factors of pulmonary infection after tracheotomy in patients with stroke coma (P＜0.05). ROC analysis results showed that the critical point (threshold C) of tracheotomy time was 4.3 days, and the sensitivity and specificity were 0.851 and 0.918 respectively. Conclusion: The main pathogenic bacteria of pulmonary infection after tracheotomy in patients with stroke coma is gram-negative bacteria, age 45 years old, complicated with basic disease, time of tracheotomy 5d, use of broad-spectrum antibiotics, smoking history and the establishment of artificial airway can lead to pulmonary infection after tracheotomy in patients with stroke coma, and the risk of pulmonary infection in patients with stroke coma will increase considerably after the time of tracheotomy for more than 4.3 days. Targeted measures should be taken to reduce the risk of pulmonary infection according to pathogenic features and risk factors. [ABSTRACT FROM AUTHOR]