| Abstract |
Objective Probe the pathogen characteristics and high-risk elements of lung infection in chronic cardiac failure complicated with chronic renal disease. Methods Retrospectively selected 250 cases of patients with chronic cardiac failure complicated by chronic renal disease treated from January 2020 to May 2024 at the Third Peoples Hospital of Yunnan Province as the research objects. Sufferers were divided into two groups based on whether they developed pulmonary infection: the pulmonary infection group (n=121) and the non-lung infection group (n=129). Clinical data of sufferers with chronic cardiac failure and chronic renal disease were collected, including gender, age, smoking history, history of invasive procedures (blood or peritoneal dialysis, central venous catheterization, etc., excluding peripheral superficial venipuncture), heart rate, cardiac rhythm, cardiac function classification, hemoglobin (HB), high - sensitivity C - reactive protein (CRP), ventricular ejection fraction (EF), and serum albumin (ALB). The current status and etiological characteristics of lung infections were statistically analyzed. The methods used were univariate analysis and multivariate logistic regression analysis, to dissect the independent risk factors for lung infection in sufferers with chronic cardiac failure and chronic renal disease. The method employed was to draw the Receiver Operating Characteristic (ROC) curves to analyze the predictive value of relevant influencing elements on lung infections in sufferers with chronic cardiac failure and chronic renal disease. Results Out of 250 cases of sufferers with chronic cardiac failure complicated by chronic renal disease, 121 had concurrent pulmonary infections, with an attack rate of 48.4%. A total of 25 bacterial strains were cultured, among them, 10 strains were Gram-positive bacteria, accounting for 40%, mainly Staphylococcus aureus, Streptococcus pneumoniae, Staphylococcus epidermidis; 13 of them were Gram-negative bacteria, accounting for 52%, mainly Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter cloacae, and Stenotrophomonas maltophilia; and 2 fungal strains, accounting for 8%, mainly Candida albicans and Aspergillus species. A history of smoking, poor cardiac function classification, invasive procedures, high levels of C-reactive protein (CRP), and low contents of serum albumin are all stand-alone risk factors for lung infection in sufferers with chronic cardiac failure and chronic renal disease (P<0.05). The level of CRP has high predictive worth for pulmonary infection in sufferers with chronic cardiac failure and chronic renal disease (AUC=0.888), and indicators such as heart function grading, invasive procedures, and smoking also have certain discriminative power. Conclusion Patients with chronic cardiac failure complicated by chronic renal disease have a high rate of pulmonary infections. In addition to the common Streptococcus pneumoniae infection, the infection rates of Gram-negative bacteria such as Klebsiella pneumoniae, Acinetobacter baumannii and fungi are high. Clinically, targeted treatments and intervention measures can be provided to these patients based on the risk factors for pulmonary infection.
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