糖尿病合并慢性鼻窦炎患者鼻分泌物培养结果及术后复发影响因素分析。

IF 4.6 3区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Xing Liu, Qian-Qian Wang, Shou-Yan Qiao, Xiao-Ning Zhu
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引用次数: 0

摘要

背景:在糖尿病患者中,持续的高血糖为致病菌的增殖创造了最佳环境,导致严重的并发症。因此,慢性鼻窦炎(CRS)合并糖尿病在临床上非常普遍。目的:分析糖尿病合并CRS患者鼻分泌物培养结果,探讨影响术后复发的因素。方法:回顾性分析2021年1月至2023年1月在青岛大学附属青岛海泽医院行Messerklinger技术治疗的203例糖尿病CRS合并鼻息肉患者的临床资料。术前进行鼻分泌物培养,以确定病原菌的类型和分布,并评估药物敏感性。在为期一年的随访中,将患者分为复发组和非复发组,分析其临床数据的差异。采用单因素和多因素分析确定影响术后复发的因素。结果:203例糖尿病合并CRS患者鼻分泌物标本中检出致病菌153例。共分离鉴定病原菌134株,其中革兰氏阳性菌81株(60.4%),革兰氏阴性菌53株(39.6%)。革兰氏阳性菌对青霉素G和红霉素表现出较高的耐药性,而对万古霉素、庆大霉素和利福平保持高度敏感。革兰氏阴性菌对头孢唑啉和庆大霉素有较高的耐药性,对亚胺培南、美罗培南、头孢吡肟和头孢他啶有较高的敏感性。单因素分析显示复发组和非复发组在空腹血糖水平、吸烟史、隆德-麦凯评分、视觉模拟量表(VAS)评分、鼻中隔偏曲、变应性鼻炎、支气管哮喘、术后感染、长期使用减充血剂和遵守医疗处方方面存在统计学差异。多因素回归分析发现空腹血糖水平和vas测量的鼻症状严重程度评分是影响术后复发的独立因素。结论:CRS合并鼻息肉(CRSwNP)患者鼻腔病原菌检出率较高,且大部分分离菌均表现出耐药性。此外,CRS合并CRSwNP患者的血糖水平是术后复发的危险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Analysis of nasal secretion culture results in diabetic patients with chronic rhinosinusitis and factors influencing postoperative recurrence.

Background: In diabetic patients, persistent hyperglycemia creates an optimal environment for the proliferation of pathogenic bacteria, resulting in severe complications. Consequently, chronic rhinosinusitis (CRS) complicated by diabetes is highly prevalent in clinical settings.

Aim: To analyze the results of nasal secretion cultures in diabetic patients with CRS and identify the factors influencing postoperative recurrence.

Methods: A retrospective analysis was conducted on the clinical data of 203 diabetic patients with CRS with nasal polyps who underwent the Messerklinger technique at Qingdao Hiser Hospital Affiliated of Qingdao University between January 2021 and January 2023. Preoperative nasal secretions were cultured to determine the types and distribution of pathogenic bacteria and assess antimicrobial susceptibility. Based on a one-year follow-up, patients were categorized into recurrence and nonrecurrence groups to analyze differences in their clinical data. Univariate and multivariate analyses were used to identify factors influencing postoperative recurrence.

Results: Pathogens were detected in 153 of the 203 nasal secretion specimens collected from diabetic patients with CRS. A total of 134 pathogenic bacteria strains were isolated and identified, including 81 strains (60.4%) of gram-positive bacteria and 53 strains (39.6%) of gram-negative bacteria. Gram-positive bacteria exhibited relatively high resistance to penicillin G and erythromycin, while remaining highly sensitive to vancomycin, gentamicin, and rifampicin. Gram-negative bacteria demonstrated relatively high resistance to cefazolin and gentamicin, but showed high sensitivity to imipenem, meropenem, cefepime, and ceftazidime. Univariate analysis revealed statistically significant differences between the recurrence and nonrecurrence groups in fasting blood glucose levels, smoking history, Lund-Mackay scores, visual analog scale (VAS) scores, nasal septum deviation, allergic rhinitis, bronchial asthma, postoperative infection, long-term use of nasal decongestants, and adherence to medical prescriptions. Multivariate regression analysis identified fasting blood glucose levels and VAS-measured nasal symptom severity scores as independent factors influencing postoperative recurrence.

Conclusion: In CRS patients with nasal polyps (CRSwNP), the detection rate of nasal pathogens is relatively high, and most of the isolated bacteria exhibit antimicrobial resistance. Additionally, the blood glucose level of patients with CRS combined with CRSwNP is a risk factor for postoperative recurrence.

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来源期刊
World Journal of Diabetes
World Journal of Diabetes ENDOCRINOLOGY & METABOLISM-
自引率
2.40%
发文量
909
期刊介绍: The WJD is a high-quality, peer reviewed, open-access journal. The primary task of WJD is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of diabetes. In order to promote productive academic communication, the peer review process for the WJD is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJD are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in diabetes. Scope: Diabetes Complications, Experimental Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Diabetes, Gestational, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Coma, Diabetic Ketoacidosis, Diabetic Nephropathies, Diabetic Neuropathies, Donohue Syndrome, Fetal Macrosomia, and Prediabetic State.
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