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已发表论文
老年肺部细菌感染患者死亡的风险因素、病原体分布和治疗策略
Authors Chen Z, Bai N, Chi Y, Liang B, Cai Y
Received 29 September 2025
Accepted for publication 19 January 2026
Published 4 February 2026 Volume 2026:21 571155
DOI https://doi.org/10.2147/CIA.S571155
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Zhi-Ying Wu
Zehua Chen,1,2,* Nan Bai,1,* Yulong Chi,1,2 Beibei Liang,1 Yun Cai1
1Center of Medicine Clinical Research, Department of Pharmacy, Medical Supplies Center, Chinese PLA General Hospital, Beijing, People’s Republic of China; 2Medical School of Chinese PLA, Graduate School of Chinese PLA General Hospital, Beijing, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Beibei Liang, Email jerryzhbc@163.com Yun Cai, Email caicai_hh@126.com
Background: Elderly patients are particularly vulnerable to pulmonary infections due to immune system decline and comorbidities. This study aims to evaluate the distribution of bacterial pathogens, patterns of antimicrobial resistance, medication strategies, and risk factors associated with mortality in elderly patients with pulmonary infections.
Methods: Data were collected from electronic medical records, encompassing demographic information, clinical characteristics, laboratory results, treatment strategies, and outcomes. Risk factors associated with mortality were identified using the Least Absolute Shrinkage and Selection Operator regression model and were subsequently validated through multivariable logistic regression. Differences between groups were assessed using the independent t-test or Mann–Whitney U-test for continuous variables, and the chi-square test or Fisher’s exact test for categorical variables.
Results: 201 patients were included with 70.6% being male. Clinical improvement was observed in 124 patients, while 77 patients died. Gram-negative bacteria were identified as the most common pathogens, with Acinetobacter baumannii (27.5%), Klebsiella pneumoniae (23.5%), and Pseudomonas aeruginosa (13.2%) being the most frequently isolated species. Notably, 66.0% of the bacterial strains were classified as multidrug-resistant. Furthermore, 65.7% of the patients received combination therapy. Seven risk factors associated with mortality were identified. Body mass index emerged as a protective factor, whereas length of duration, gastrointestinal bleeding, respiratory failure, bacteremia, myocardial infarction, and mechanical ventilation significantly increased the risk of death.
Conclusion: Respiratory failure, mechanical ventilation, gastrointestinal bleeding, extended hospitalization, bacteremia, myocardial infarction, and malnutrition were key risk factors related to mortality in elderly patients with pulmonary infections. Early identification and intervention targeting these risk factors are crucial for improving clinical outcomes.
Keywords: elderly patients, pulmonary infection, multidrug-resistant bacteria, MDRB, risk factors
1Center of Medicine Clinical Research, Department of Pharmacy, Medical Supplies Center, Chinese PLA General Hospital, Beijing, People’s Republic of China; 2Medical School of Chinese PLA, Graduate School of Chinese PLA General Hospital, Beijing, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Beibei Liang, Email jerryzhbc@163.com Yun Cai, Email caicai_hh@126.com
Background: Elderly patients are particularly vulnerable to pulmonary infections due to immune system decline and comorbidities. This study aims to evaluate the distribution of bacterial pathogens, patterns of antimicrobial resistance, medication strategies, and risk factors associated with mortality in elderly patients with pulmonary infections.
Methods: Data were collected from electronic medical records, encompassing demographic information, clinical characteristics, laboratory results, treatment strategies, and outcomes. Risk factors associated with mortality were identified using the Least Absolute Shrinkage and Selection Operator regression model and were subsequently validated through multivariable logistic regression. Differences between groups were assessed using the independent t-test or Mann–Whitney U-test for continuous variables, and the chi-square test or Fisher’s exact test for categorical variables.
Results: 201 patients were included with 70.6% being male. Clinical improvement was observed in 124 patients, while 77 patients died. Gram-negative bacteria were identified as the most common pathogens, with Acinetobacter baumannii (27.5%), Klebsiella pneumoniae (23.5%), and Pseudomonas aeruginosa (13.2%) being the most frequently isolated species. Notably, 66.0% of the bacterial strains were classified as multidrug-resistant. Furthermore, 65.7% of the patients received combination therapy. Seven risk factors associated with mortality were identified. Body mass index emerged as a protective factor, whereas length of duration, gastrointestinal bleeding, respiratory failure, bacteremia, myocardial infarction, and mechanical ventilation significantly increased the risk of death.
Conclusion: Respiratory failure, mechanical ventilation, gastrointestinal bleeding, extended hospitalization, bacteremia, myocardial infarction, and malnutrition were key risk factors related to mortality in elderly patients with pulmonary infections. Early identification and intervention targeting these risk factors are crucial for improving clinical outcomes.
Keywords: elderly patients, pulmonary infection, multidrug-resistant bacteria, MDRB, risk factors