Evaluation of the distribution of pathogenic bacteria and nutritional status in elderly patients with diabetes mellitus complicated with hospital acquired pneumonia
WANG Kunfang
XU Shenghui
YU Kaina
XIE Xuan
Abstract：Objective To investigate the distribution of pathogenic bacteria and nutritional status in elderly patients with diabetes mellitus(DM)complicated with hospital acquired pneumonia(HAP).Methods Two hundred and sixty-four elderly patients with DM admitted from May 2022 to February 2024 were selected and divided into pneumonia group(n=52)and non-pneumonia group(n=212)based on the presence or absence of complicated HAP.The distribution of pathogenic bacteria in the pneumonia group was observed,and the mini nutritional assessment(MNA)score and nutritional biochemical indexes[albumin(Alb),prealbumin(PA),transferrin(TRF),hemoglobin(HGB),cholesterol(CHOL),low-density lipoprotein(LDL)]were compared between the two groups.According to the MNA score,the pneumonia group was divided into malnutrition subgroup and normal nutrition subgroup,and the immune function indexes[CD4+,CD8+,CD4+/CD8+,immunoglobulin G(IgG),lymphocyte count]and prognosis[frequency of invasive ventilator use,pneumonia severity index(PSI)]were compared between the two subgroups.Results A total of 69 strains of pathogens were isolated from 52 patients with HAP,and 46 strains(66.67%)were Gram-negative bacteria,including Klebsiella pneumoniae,Acinetobacter baumannii,Pseudomonas aeruginosa and Escherichia coli.Additionally,19 strains(27.54%)of gram-positive bacteria were detected,including Staphylococcus aureus and Streptococcus pneumoniae,and 4 strains of fungi(5.80%)were detected,all of which were Candida albicans.The pneumonia group had a significantly lower total score of MNA than the non-pneumonia group(P<0.05).The pneumonia group had significantly lower Alb,PA,and TRF than the non-pneumonia group(P<0.05).The lymphocyte count,IgG,CD4+and CD4+/CD8+ratio were significantly lower in the malnutrition subgroup than in the normal nutrition subgroup(P<0.05).The malnutrition subgroup had significantly higher PSI and frequency of invasive ventilator use than the normal nutrition subgroup(P<0.05).Conclusion Gram-negative bacteria are the main pathogens in elderly patients with DM complicated with HAP,and the nutritional status of the body can affect the prognosis.It is suggested that clinical attention should be paid to the nutritional status of these patients and reduce their malnutrition,so as to improve the prognosis and reduce the mortality.
Keywords：diabetes mellitushospital acquired infectionpneumoniapathogenic bacteriaalbuminprealbuminimmune globulin
Publication Date：2025-09-13
Online Publishing Date：2025-09-23(First online date of this platform, not the publication date of the document)
Pages：5( 34-38 )