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Abstract：
OBJECTIVE: To investigate the association between meteorological data three days before admission and the status of sputum pathogens culture in hospitalized patients with Acute exacerbation of Chronic obstructive pulmonary disease (AECOPD) and respiratory infections.
METHODS: Data from 1,370 AECOPD patients (80.66% males, approximately 80% age > 70) with respiratory infections hospitalized in Fujian Provincial Hospital between December 2013 and December 2019 were collected. This cohort comprised, along with concurrent meteorological data from Fuzhou. Group differences were analyzed to compare the meteorological data three days prior to admission between patients with positive sputum pathogen cultures and those without. Logistic regression models were employed to investigate the association between meteorological parameters and the status of sputum pathogen cultures in patients with AECOPD and respiratory infections. Sensitivity analyses was conducted among the hospitalized patients from 2013 to 2016 and 2017-2019. Stratified analysis was performed to explore the factors affecting the effect of temperature differences and their interactions.
RESULTS: 578(42.19%) cases had a positive sputum culture report indicating pathogen growth. 323 cases were found with Gram-negative bacteria, 160 with Gram-positive bacteria, and 114 with fungi. Uni-variate analysis revealed statistical differences in DTD three days prior to admission (DTD-3d) between the positive and negative sputum culture groups (p = 0.019). Multivariate analysis indicated that an increase in the risk of positive sputum pathogen cultures was associated with greater DTD three days before admission (DTD-3d), with OR1.657 (95%CI [ 1.328-1.981]). The risk of positive sputum pathogen cultures was higher in groups with greater DTD-3d. The findings were consistent across different admission periods. Stratified analysis showed that patients without respiratory failure were more affected by DTD-3d, and an interaction effect was observed (p < 0.001).
CONCLUSIONS: In coastal areas, the diurnal temperature difference three days prior to admission affects the sputum pathogen status in AECOPD patients with respiratory infections.
METHODS: Data from 1,370 AECOPD patients (80.66% males, approximately 80% age > 70) with respiratory infections hospitalized in Fujian Provincial Hospital between December 2013 and December 2019 were collected. This cohort comprised, along with concurrent meteorological data from Fuzhou. Group differences were analyzed to compare the meteorological data three days prior to admission between patients with positive sputum pathogen cultures and those without. Logistic regression models were employed to investigate the association between meteorological parameters and the status of sputum pathogen cultures in patients with AECOPD and respiratory infections. Sensitivity analyses was conducted among the hospitalized patients from 2013 to 2016 and 2017-2019. Stratified analysis was performed to explore the factors affecting the effect of temperature differences and their interactions.
RESULTS: 578(42.19%) cases had a positive sputum culture report indicating pathogen growth. 323 cases were found with Gram-negative bacteria, 160 with Gram-positive bacteria, and 114 with fungi. Uni-variate analysis revealed statistical differences in DTD three days prior to admission (DTD-3d) between the positive and negative sputum culture groups (p = 0.019). Multivariate analysis indicated that an increase in the risk of positive sputum pathogen cultures was associated with greater DTD three days before admission (DTD-3d), with OR1.657 (95%CI [ 1.328-1.981]). The risk of positive sputum pathogen cultures was higher in groups with greater DTD-3d. The findings were consistent across different admission periods. Stratified analysis showed that patients without respiratory failure were more affected by DTD-3d, and an interaction effect was observed (p < 0.001).
CONCLUSIONS: In coastal areas, the diurnal temperature difference three days prior to admission affects the sputum pathogen status in AECOPD patients with respiratory infections.
摘要：
目的：探讨慢性阻塞性肺疾病急性加重期(AECOPD)合并呼吸道感染住院患者入院前3天的气象数据与痰病原菌培养状况的关系。
方法：数据来自1,370例AECOPD患者（80.66％为男性，收集了2013年12月至2019年12月期间在福建省立医院住院的约80％年龄>70）的呼吸道感染患者。这个队列包括，同时还有福州的气象数据。分析了组差异，以比较痰病原体培养阳性的患者和没有痰病原体培养的患者入院前三天的气象数据。采用Logistic回归模型研究AECOPD合并呼吸道感染患者痰病原菌培养状况与气象参数的关系。对2013年至2016年和2017年至2019年的住院患者进行了敏感性分析。进行了分层分析，以探讨影响温差效应的因素及其相互作用。
结果：578例（42.19%）痰培养报告阳性，表明病原体生长。323例发现革兰氏阴性菌，160与革兰氏阳性菌，和114真菌。单变量分析显示，阳性和阴性痰培养组之间入院前三天（DTD-3d）的DTD存在统计学差异（p=0.019）。多变量分析表明，痰病原体培养阳性的风险增加与入院前三天（DTD-3d）的DTD增加有关，OR1.657（95CI[1.328-1.981]）。在DTD-3d较大的组中，痰病原体培养阳性的风险更高。研究结果在不同的入院期间是一致的。分层分析显示,无呼吸衰竭患者受DTD-3d影响较大,并观察到相互作用效应(p<0.001)。
结论：在沿海地区，入院前3天的昼夜温差影响AECOPD合并呼吸道感染患者的痰菌状态.
方法：数据来自1,370例AECOPD患者（80.66％为男性，收集了2013年12月至2019年12月期间在福建省立医院住院的约80％年龄>70）的呼吸道感染患者。这个队列包括，同时还有福州的气象数据。分析了组差异，以比较痰病原体培养阳性的患者和没有痰病原体培养的患者入院前三天的气象数据。采用Logistic回归模型研究AECOPD合并呼吸道感染患者痰病原菌培养状况与气象参数的关系。对2013年至2016年和2017年至2019年的住院患者进行了敏感性分析。进行了分层分析，以探讨影响温差效应的因素及其相互作用。
结果：578例（42.19%）痰培养报告阳性，表明病原体生长。323例发现革兰氏阴性菌，160与革兰氏阳性菌，和114真菌。单变量分析显示，阳性和阴性痰培养组之间入院前三天（DTD-3d）的DTD存在统计学差异（p=0.019）。多变量分析表明，痰病原体培养阳性的风险增加与入院前三天（DTD-3d）的DTD增加有关，OR1.657（95CI[1.328-1.981]）。在DTD-3d较大的组中，痰病原体培养阳性的风险更高。研究结果在不同的入院期间是一致的。分层分析显示,无呼吸衰竭患者受DTD-3d影响较大,并观察到相互作用效应(p<0.001)。
结论：在沿海地区，入院前3天的昼夜温差影响AECOPD合并呼吸道感染患者的痰菌状态.
