新型冠状病毒感染后继发肺部感染的病原学特征及危险因素分析

Pathological Characteristics and Risk Factors of Secondary Pulmonary Infections following COVID-19 Infection

摘要: 目的：研究新型冠状病毒感染患者继发肺部感染的危险因素及病原学特征。方法：选取2023年1月~2025年1月就诊于华北理工大学附属医院呼吸科及重症医学科住院治疗的新型冠状病毒感染患者为研究对象。选择其中继发肺部感染的患者作为病例组，未继发肺部感染的患者为对照组。根据患者病历收集临床资料，分析病例组常见病原菌分布情况，比较病例组和对照组各项指标，采用条件Logistic回归分析研究新型冠状病毒继发肺部感染的危险因素。结果：84例感染组患者中，痰培养共检出病原菌94株，其中革兰氏阴性菌55株，革兰氏阴性菌15株，真菌24株。白细胞绝对值、CRP、PCT、白蛋白数值、氧分压以及氧合指数是独立危险因素。结论：新型冠状病毒继发肺部感染患者常见病原菌为革兰氏阴性菌，其次为真菌。白细胞绝对值、CRP、PCT、白蛋白数值、氧分压以及氧合指数是新型冠状病毒感染后继发肺部感染的独立危险因素。

Abstract: Purpose: To study the risk factors and etiological characteristics of secondary pulmonary infection in patients infected with the novel coronavirus. Methods: Patients infected with the novel coronavirus who were hospitalized in the Department of Respiratory Medicine and Department of Critical Care Medicine of Affiliated Hospital of North China University of Science and Technology from January 2023 to January 2025 were selected as the study subjects. Patients with secondary pulmonary infection were assigned to the case group, while those without secondary pulmonary infection were assigned to the control group. Clinical data were collected from the medical records of the patients. The distribution of common pathogens in the case group was analyzed, and various indicators were compared between the case and control groups. Conditional Logistic regression analysis was used to study the risk factors for secondary pulmonary infection following novel coronavirus infection. Results: Among the 84 patients with infection, sputum cultures detected a total of 94 strains of pathogens, including 55 strains of Gram-negative bacteria, 15 strains of Gram-positive bacteria, and 24 strains of fungi. The absolute value of white blood cells, CRP, PCT, albumin levels, partial pressure of oxygen, and oxygenation index were identified as independent risk factors. Conclusion: The common pathogens in patients with secondary pulmonary infection following novel coronavirus infection are Gram-negative bacteria, followed by fungi. The absolute value of white blood cells, CRP, PCT, albumin levels, partial pressure of oxygen, and oxygenation index are independent risk factors for secondary pulmonary infection following novel coronavirus infection.