铜绿假单胞菌合并曲霉菌感染患者的临床特征及危险因素分析

Clinical Characteristics and Risk Factors Analysis of Patients with Co-Infection of Pseudomonas aeruginosa and Aspergillus

摘要: 目的：通过对铜绿假单胞菌合并曲霉菌感染的患者进行分析，了解铜绿假单胞菌合并曲霉菌感染在临床患者中的流行情况及患者的临床特征，了解铜绿假单胞菌合并曲霉菌感染的临床现状，并且通过对合并感染的患者进行预后不佳危险因素的单因素、多因素分析，为铜绿假单胞菌合并曲霉菌感染的临床治疗提供参考，以期制定合理的诊疗策略，改善患者预后。方法：回顾性收集2013年2月至2022年10月青岛大学附属医院铜绿假单胞菌及曲霉菌培养阳性标本60例，总结临床特征，筛选出单因素危险因素，分析预后良好组和预后不佳组的临床资料，再对单因素危险因素中有统计学意义的因素采用Logistic多因素回归分析，导致预后不良的影响因素，按检验水准P < 0.05表示差异具有统计学意义，得出独立危险因素和独立保护因素。结果：应用抗真菌药物、中性粒细胞百分比、血小板、C反应蛋白(CRP)水平是铜绿假单胞菌合并曲霉菌感染导致预后不佳的单因素危险因素；应用抗真菌药物、血小板水平是铜绿假单胞菌合并曲霉菌感染预后的独立保护因素；C反应蛋白(CRP)水平为独立危险因素，中性粒细胞百分比是非独立危险因素。

Abstract: Objective: This study aims to analyze patients with Pseudomonas aeruginosa co-infected with Aspergillus to understand the epidemiological characteristics and clinical features of such infections. By investigating the clinical status of co-infections and conducting univariate and multivariate analyses of risk factors associated with poor prognosis, the study seeks to provide clinical insights for the treatment of Pseudomonas aeruginosa and Aspergillus co-infections. The ultimate goal is to formulate rational diagnostic and therapeutic strategies to improve patient outcomes. Methods: A retrospective analysis was conducted on 60 cases of Pseudomonas aeruginosa and Aspergillus co-infection at the Affiliated Hospital of Qingdao University between February 2013 and October 2022. Clinical characteristics were summarized. Univariate analysis was used to identify risk factors for poor prognosis, and clinical data of the good prognosis group and the poor prognosis group were compared. Factors with statistical significance in univariate analysis were further analyzed using multivariate logistic regression to determine independent risk and protective factors associated with poor prognosis. Statistical significance was set at P < 0.05. Results: The use of antifungal drugs, neutrophil percentage, platelet count, and C-reactive protein (CRP) levels were identified as univariate risk factors for poor prognosis in patients with Pseudomonas aeruginosa co-infected with Aspergillus. The administration of antifungal drugs and platelet count emerged as independent protective factors for prognosis in these co-infected cases. Specifically, C-reactive protein (CRP) levels were determined to be an independent risk factor, while neutrophil percentage was identified as a non-independent risk factor for clinical outcomes.