Etiological distribution of multidrug-resistant organism infection in patients with acute exacerbation of chronic obstructive pulmonary disease and its relationship with Th1/Th2 cytokine content

YANG Lina; ZHANG Wenai; MA Xuemei; MENG Linlin

doi:10.3969/j.issn.1002-3429.2026.01.006

Abstract：Objective To investigate the etiological distribution of multidrug-resistant organism(MDRO)infection and its relationship with Th1/Th2 cytokine levels in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Two hundred patients with AECOPD admitted from April 2022 to July 2024 were selected as the research subjects.The MDRO infection and etiological distribution were recorded.According to presence of MDRO infection,they were divided into MDRO group and non-MDRO group.The general data and Th1/Th2 cytokine level of the two groups were compared,to analyze the correlation between Th1/Th2 cytokines and clinical characteristics.Multivariate logistic regression was used to analyze the influencing factors of MDRO infection,and the prediction model was constructed accordingly.Its value for predicting MDRO infection was evaluated using receiver operating characteristic curves.Results A total of 60 patients with MDRO infection occurred in 200 patients with AECOPD,and 137 strains of MDRO were isolated.There were significant differences in acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,forced expiratory volume in one second to forced vital capacity ratio(FEV1/FVC),FEV1 percentage of predicted value(FEV1％),use of antibiotics in the past 3 months,invasive mechanical ventilation and serum interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),interleukin(IL)-4 and IL-13 levels between the two groups(P＜0.05).The serum levels of IFN-γ,TNF-α,IL-4 and IL-13 in patients with MDRO infection were positively correlated with APACHE Ⅱ score,use of antibiotics in the past 3 months,and invasive mechanical ventilation,and negatively correlated with FEV1/FVC and FEV1％(P＜0.05).The use of antibiotics in the past 3 months,invasive mechanical ventilation and serum IFN-γ,TNF-α,IL-4 and IL-13 levels were the influencing factors of MDRO infection in AECOPD patients(P＜0.05).Delong test showed that the area under the receiver operating characteristic(ROC)curve(AUC)of Th1/Th2 cytokine model and combined model in predicting MDRO infection was better than that of clinical model(P＜0.05).Conclusion MDRO infection in AECOPD patients is closely related to the changes of Th1/Th2 cytokines.The use of antibiotics in the past 3 months,invasive mechanical ventilation and serum IFN-γ,TNF-α,IL-4 and IL-13 levels are the influencing factors of MDRO infection in AECOPD patients.The prediction model based on the above factors has a higher predictive value for MDRO infection.