| Objective:To explore the clinical characteristics,drug susceptibility results and prognostic risk factors of pulmonary infection caused by Stenotrophomonas maltophilia(Stenotrophomonas maltophilia)in hospitalized patients in the first affiliated hospital of Soochow university,so as to deepen clinicians’ understanding of Stenotrophomonas maltophilia associated pneumonia and provide evidence for clinical prevention and control of infection,rational selection of antibiotics and reduction of the incidence of drug-resistant bacteria.Methods:A total of 200 patients with pulmonary infection caused by Stenotrophomonas maltophilia in the first affiliated hospital of Soochow university from October 2021 to October 2022 were selected.After checking the relevant electronic medical records,according to their clinical outcomes,the surviving patients were set as the survival group,and the dead patients were set as the death group.The clinical characteristics,antibiotic use and drug sensitivity of the two groups of patients with pulmonary infection caused by Stenotrophomonas maltophilia were recorded respectively for statistical description.The mean of the two samples was compared by t-test,the counting data was tested by x 2 test,and the measurement data of abnormal distribution was described by median,and the nonparametric test was used.For the influencing factors with statistical significance(p<0.05)as independent variables,binary Logistic regression analysis was used to calculate the independent risk factors related to death.At the same time,the drug sensitivity results of all strains were collected to calculate the drug resistance rate of the strains to cefoperazone sulbactam,ceftazidime,compound sulfamethoxazole,levofloxacin and minocycline.Result:(1)Of the 200 patients with S.maltophilia pneumonia,139 patients(69.5%)were aged ≥60 years.The majority of patients had at least one underlying disease,128(64%)had cardiovascular disease,83(41.5%)had malignant neoplasms,including 46 malignant solid tumors and 37 hematologic tumors,70(35%)had immunosuppression,70(35%)had hypoproteinemia,69(34.5%)had chronic pulmonary disease;68(34%)patients combined with cranial cerebrovascular disease;46(23%)patients combined with liver disease;46(23%)patients combined with chronic kidney disease;and 43(21.5%)patients combined with diabetes mellitus.(2)Among the 200 clinical isolates of Clostridium perfringens,the following drug sensitivity results were obtained:cefoperazone sulbactam was 50.5%,with 101 sensitive,61 intermediary and 38 resistant strains;ceftazidime was 52.5%,with 105 sensitive,8 intermediary and 87 resistant strains;minocycline was 94.5%,with 189 sensitive,9 intermediary and 2 resistant strains;levofloxacin was 86.5%,with 173 sensitive,4 intermediary and 23 resistant strains.The sensitivity rate of minocycline was 94.5%,including 189 sensitive strains,9 intermediary strains and 2 drug-resistant strains;the sensitivity rate of levofloxacin was 86.5%,including 173 sensitive strains,4 intermediary strains and 23 drug-resistant strains;the sensitivity rate of cotrimoxazole was 94.5%,including 189 sensitive strains,3 intermediary strains and 8 drug-resistant strains.(3)The group of patients who died had mechanical ventilation,co-infection with other pathogens,multi-drug resistant bacteria,surgery,infectious shock,co-malignancy,co-chronic lung disease,3 or more antibiotics applied before diagnosis,hypoproteinemia(P=0.001),immunosuppressive status and APACHE II(Acute Physiology and Chronic Health Evaluation Ⅱ)score>18(P<0.001)were significantly higher than in the surviving patient group.Multifactorial logistic regression analysis confirmed mechanical ventilation(p=0.049),combined malignancy(p=0.025),immunosuppressive status(p=0.040),APACHEⅡ score>18(p<0.001),and infectious shock(p=0.017)as independent risk factors for death associated with patients with S.maltophilia pneumonia.Conclusion:1.The majority of patients with S.maltophilia pulmonary infections are elderly and have a high mortality rate.Immunocompromised patients with co-morbidities,co-infections with other pathogens and in critical condition are more likely to develop S.maltophilia pneumonia.2.Stenotrophomonas maltophilia had the highest susceptibility to cotrimoxazole and minocycline and the highest resistance rate to ceftazidime.3.APACHE Ⅱ score>18,infectious shock,immunosuppressive state,combined malignancy,and mechanical ventilation are independent risk factors for death associated with patients with Stenotrophomonas maltophilia pneumonia. |
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