FENG Haipai 1,3 , ZHOU Chen 2 , LUO Yuanming 4 , WEI Hailong 5 , GE Huiqing 6 , LIU Huiguo 7 , ZHANG Jianchu 8 , PAN Pinhua 9 , LI Xianhua 10 , ZHOU Hui 11 , XIE Xiufang 10 , CHENG Lina 12 , YI Mengqiu 12 , ZHANG Jiarui 1 , Adila ·Aili 1 , PENG Lige 1 , LIU Yu 1 , PU Jiaqi 1 , LIU Liang 11 , ZHANG Xiaohong 3 , ZHOU Haixia 1 , YI Qun 1,13
  • 1. Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
  • 2. West China Medical College of Sichuan University, Chengdu, Sichuan 610041, P. R. China;
  • 3. Department of Respiratory and Critical Care Medicine, Chengdu Sixth People's Hospital, Chengdu, Sichuan 610051, P. R. China;
  • 4. State Key Laboratory of Respiratory Diseases, Guangzhou Medical University, Guangzhou, Guangdong 510120, P. R. China;
  • 5. Department of Respiratory and Critical Care Medicine, Leshan People's Hospital of Sichuan Province, Leshan, Sichuan 614000, P. R. China;
  • 6. Department of Respiratory and Critical Care Medicine, Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310000, P. R. China;
  • 7. Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P. R. China;
  • 8. Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P. R. China;
  • 9. Department of Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410000, P. R. China;
  • 10. Department of Respiratory and Critical Care Medicine, Neijiang First People's Hospital, Neijiang, Sichuan 641000, P. R. China;
  • 11. Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Chengdu University, Chengdu, Sichuan 610081, P. R. China;
  • 12. Department of Emergency, Jiujiang First People's Hospital, Jiujiang, Jiangxi 332000, P. R. China;
  • 13. Sichuan Cancer Hospital, Chengdu, Sichuan 610042, P. R. China;
ZHOU Haixia, Email: zhouhaixia925@163.com; YI Qun, Email: yiqun925@126.com
Chronic obstructive pulmonary disease; acute exacerbation; Pseudomonas aeruginosa infection; risk factors; clinical features
10.7507/1671-6205.202302025
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Objective To study the clinical features, short-term prognosis and risk factors of Pseudomonas Aeruginosa (P.aeruginosa) infection in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods This study enrolled patients hospitalized for AECOPD in ten tertiary hospitals of China from September 2017 to July 2021. AECOPD patients with P.aeruginosa infection were included as case group, AECOPD patients without P.aeruginosa infection were randomly selected as control group from the same hospitals and same hospitalization period as the patients in case group, at a ratio of 2∶1. The differences in basic conditions, complications, clinical manifestations on admission and in-hospital prognosis between the two groups were compared, and the risk factors of P.aeruginosa infection were analyzed. Results A total of 14007 inpatients with AECOPD were included in this study, and 338 patients were confirmed to have P.aeruginosa infection during hospitalization, with an incidence rate of 2.41%. The in-hospital prognosis of AECOPD patients with P.aeruginosa infection was worse than that of the control group, which was manifested in higher hospital mortality (4.4% vs. 1.9%, P=0.02) and longer hospital stay [13.0 (9.0, 19.25)d vs. 11.0 (8.0, 15.0)d, P=0.002]. In terms of clinical features, the proportions of patients with cough, expectoration, purulent sputum, dyspnea in the case group were higher than those in the control group, and the inflammatory indicators (neutrophil ratio, erythrocyte sedimentation rate) and partial pressure of carbon dioxide in arterial blood gas were higher than those in the control group, while the serum albumin was significantly lower than that in the control group (all P<0.05). Multivariate logistic regression analysis showed that Parkinson's disease [odds ratio (OR)=5.14, 95% confidence interval (CI): 1.43 to 18.49, P=0.012], bronchiectasis (OR=4.97, 95%CI: 3.70 to 6.67, P<0.001), invasive mechanical ventilation (OR=2.03, 95%CI: 1.23 to 3.36, P=0.006), serum albumin<35 g/L (OR=1.40, 95%CI: 1.04 to 1.88, P=0.026), partial pressure of carbon dioxide ≥45 mm Hg (OR=1.38, 95%CI: 1.01 to 1.90, P=0.046) were independent risk factors for P.aeruginosa infection in AECOPD patients. Conclusions P.aeruginosa infection has a relative high morbidity and poor outcome among AECOPD inpatients. Parkinson’s disease, bronchiectasis, invasive mechanical ventilation, serum albumin below 35 g/L, partial pressure of carbon dioxide ≥45 mm Hg are independent risk factors of P.aeruginosa infection in AECOPD inpatients.

Citation： FENG Haipai, ZHOU Chen, LUO Yuanming, WEI Hailong, GE Huiqing, LIU Huiguo, ZHANG Jianchu, PAN Pinhua, LI Xianhua, ZHOU Hui, XIE Xiufang, CHENG Lina, YI Mengqiu, ZHANG Jiarui, Adila ·Aili, PENG Lige, LIU Yu, PU Jiaqi, LIU Liang, ZHANG Xiaohong, ZHOU Haixia, YI Qun. Clinical features, short-term prognosis and risk factors of Pseudomonas aeruginosa infection in patients with acute exacerbation of chronic obstructive pulmonary disease. Chinese Journal of Respiratory and Critical Care Medicine, 2023, 22(2): 89-95. doi: 10.7507/1671-6205.202302025 Copy

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