AnalysisofPathogen DistributionCharacteristicsand InfluencingFactorsofPulmonary Infection in Tuberculosis Patients/YI Ting.//Medical Innovation of China，2025，22（18）： 163-167

[Abstract]Objective： To study pathogen distribution characteristics and influencing factors of pulmonary infection in pulmonary tuberculosis （PTB）patients.Method： A total of 102 PTB patients treated at Pingxiang Second People's Hospital from January 2O2O to December 2023 were selected for the study.They were divided into infected group （ n =34） and non-infected group（ n =68） according to whether there was concurrent PI. The influencing factors of PI in pulmonary tuberculosis patients were determined byunivariate and multivariate logistic regression analysis. In addition，sputum samples of infected patients were obtained to cary out pathogen culture and drug susceptibilitytest，and the distribution characteristics of pathogenic bacteria were analyzed.Result：Out of 102 patients， 34 developed PI， resulting in an incidence rate of 33.33% . The age， disease duration， and number of lung fields involved werehigher in the infected groupcompared to the non-infected group.Additionally，the proportions of patients who smoked，used corticosteroids foralong time，used broad-spectrum antibiotics for a long time，had chronic obstructive pulmonary disease （COPD），or underwent invasive procedures were also higher in the infected group compared to the non-infected group， with all differences being statistically significant （ P lt;0.05）. Logistic regression analysis indicated that being aged ⩾ 60 years，havinga disease duration ⩾5 years，having ≥3 lung fields involved，smoking，long-term useof corticosteroids，long-term useof broad-spectrumantibiotics，having COPD，and undergoing invasive procedures were allrisk factors for PI in patients with pulmonary tuberculosis （ P lt;0.05）. A total of 34sputumsamplesof PIpatients werecolectedandcultured，and41 strains of pathogenic bacteria wereisolated. In order of proportion from high to low，the top5pathogens were Pseudomonas aeruginosa，Klebsiela pneumoniae， Staphylococcus aureus， Streptococcus pneumoniae and Escherichia coli，accounting for 31.71 % ，21.95 % ，17.07 % ， （20 9.76% ， 7.32% ，respectively. Conclusion： The pathogenic bacteria of PTB complicated with PI are mainly gramnegativebacteria，and the influencing factors includeage，disease course，number of lung fields involved，smoking， long-term use of glucocorticoids or/and broad-spectrum antibiotics， COPD and invasive procedures.

[Key Words]Pulmonary tuberculosisPulmonary infectionsPathogenic bacteria distributionInfluencing factor

First-author'saddress： Clinical Laboratory，Pingxiang Second People's Hospital，Pingxiang 337000， China

doi：10.3969/j.issn.1674-4985.2025.18.037

肺结核（PTB）属于慢性消耗性疾病之一，病变往往累及多个脏器，加之疾病本身会对肺组织造成损伤，从而增加了肺部感染（PI）发生风险[1]。PI的发生会直接加剧PTB患者病情，且因临床表现缺乏典型性，易被患者所忽视，可能导致患者病情被延误，进一步对患者预后转归产生负面影响[2]。迄今，临床上仍难以单独依靠症状表现或/和影像学检查等确诊PTB并发PI，往往需要细菌培养进行确诊，然而细菌培养周期较长，阳性检出率较低，可能导致病情被延误[3。故而，明确PTB并发PI的相关影响因素及病原菌分布特点意义重大。目前，全球范围内有关PTB并发PI的研究较为多见，然而受地域与个体差异等因素的影响，各地区PI危险因素与病原菌分布可能存在异质性[4。鉴于此，本文通过研究本地区PTB并发PI的病原菌分布特点及并发PI影响因素，希望为本地区PTB并发PI的防治提供理论依据，现报道如下。

1资料与方法

1.1一般资料

选取从2020年1月一2023年12月收治的102例PTB患者开展研究。其中男63例，女39例；年龄32＼～84岁，平均（ 58.24±6.69 ）岁；体重指数（bodymass index，BMI）18～30kg/m² ，平均（ 23.62±1.79 ） kg/m² ；PTB病程1＼～12年，平均（ 5.07±1.22 ）年；病变累及肺野数1＼～6个，平均（ 2.85±0.51 ）个；不健康行为习惯：吸烟46例，饮酒55例；长期用药：糖皮质激素49例，广谱抗菌药物52例；合并慢性病：高血压43例，糖尿病31例，慢性阻塞性肺疾病（COPD）43例；侵人性操作31例。研究经医学伦理委员会批准，患者和家属均知情同意本研究并签署同意书。

纳入标准：（1）均与文献[5《肺结核诊断和治疗指南》中制定的PTB有关诊断标准相吻合；（2）年龄⩾18 周岁；（3）临床资料完善。排除标准：（1）肝、肾等脏器发生严重病变；……