血流细菌感染的病原菌分布及降钙素原和C反应蛋白水平差异的研究

The pathogen distribution and different levels of procalcitonin and C-reactive protein in patients with bloodstream bacterial infection

目的探讨血流细菌感染的病原菌分布情况以及降钙素原(PCT)、C反应蛋白(CRP)水平在不同细菌所致血流感染患者中的意义。方法对119例血流感染患者的血液细菌培养和PCT、CRP水平进行检测,分析血流感染的主要病原菌,并比较革兰氏阳性菌和革兰氏阴性菌感染后,患者血清中PCT、CRP水平的差异。结果血流感染的主要病原菌为大肠埃希菌、金黄色葡萄球菌和肺炎克雷伯杆菌;革兰氏阴性菌感染者血清中PCT水平显著高于革兰氏阳性菌感染者,经统计学分析差异有统计学意义(P<0.05);CRP水平在革兰氏阴性菌感染者与革兰氏阳性菌中差异均无统计学意义(P>0.05)。结论大肠杆菌、金黄色葡萄球菌、肺炎克雷伯杆菌为主要的血流感染菌,对于疑似血流感染者,血清PCT水平可用于初步鉴别革兰氏阳性和革兰氏阴性细菌引起的血流感染,为临床医生合理用药提供有效依据。

Objective To discuss the pathogen distribution and significances of different levels of procalci- tonin （PCT）, C--reactive protein （CRP） in patients with bloodstream infection induced by different bacteria. Methods Blood bacteria were cultured and PCT, CRP levels were tested for 119 cases with bloodstream in fection, the main pathogens of bloodstream infection were analyzed, and the PCT, CRP differences were com- pared after Gram-- positive bacteria and gram-- negative bacterial infections occurred. Results The main pathogens of bloodstream infections were Escherichia coli, Staphylococcus aureus and Klebsiella pneumoniae. PCT levels in patients with Gram--negative bacterial infection were significantly higher than those in patients with Gram--positive bacteria infection, comparison showed statistically significant difference （ P 〈0.05）. There was no statistically significant difference in comparison of.CRP levels between patients with Gram--neg- ative bacterial infection and patients with Gram--positive bacteria infection （ P 〉0.05）. Conclusion Esche richia coli, Staphylococcus aureus and Klebsiella pneumoniae bacteria were main pathogens of bloodstream in- fections. PCT levels can be used for preliminary identification of Gram--positive and Gram--negative bacteria for suspected bloodstream infection, and can provide an effective evidence for the rational use of drugs.