Risk Factors and Prognosis Model Analysis of Carbapenem-resistant Enterobacteriaceae Lower Respiratory Tract Infections

Shao Wei; Sheng Yuliang; Wang Yuhao; Zhang Xiaohan; Kang Xiuwen; Hu Rong

Abstract：Objective To study the risk factors of carbapenem-resistant enterobacteriaceae(CRE)combined with lower respira-tory tract infection,and establish a prediction model for this risk.Methods The clinical data of 206 patients with CRE lower respira-tory tract infection in the First People's Hospital of Lianyungang City from February 2021 to February 2023 were selected,and the en-rolled patients were divided into survival group(136 cases)and death group(70 cases)according to whether they died within 28 days,and the distribution of pathogenic bacteria and strain classification of patients with CRE lower respiratory tract infection were ana-lyzed.Univariate and multiple Logistic regression were used to analyze the influencing factors of prognosis and construct a risk predic-tion model.Receiver operating characteristic(ROC)curve was drawn to detect the prediction efficiency of this risk model for infection risk factors.Results CRE was detected mainly in the Department of Intensive Care(28.65％)and the Department of Respiratory and Critical Care(16.02％).The most common CRE isolates were Klebsiella pneumoniae(73.12％),Escherichia coli(10.85％),and Enterobacter cloacae(7.08％).Multivariate logistic regression analysis showed that acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,chronic obstructive pulmonary disease(COPD),septic shock,tracheotomy,and serum albumin<30 g/L were independent risk factors for CRE with Lower respiratory tract infection(P<0.05).The area under the curve(AUC)of the risk prediction model is 0.949(95％CI:0.920-0.979),which verifies its high accuracy and strong performance.Conclusion APACHEⅡ score,COPD,septic shock,tracheotomy and serum albumin<30 g/L are independent risk factors of CRE with lower respiratory tract infection in hospital.The risk prediction model can effectively predict the risk of infectious complications in patients.