血清降钙素原在人体感染特征及病原菌种类中的应用价值

Application Value of Serum Procalcitonin in Human Infection Characteristics and Pathogen Species

目的:了解血清降钙素原在人体感染特征及病原菌种类中的应用价值。方法:选取2019年2月-2020年2月住院的感染患者,同时进行病原学送检和PCT检测的病例711例,感染部位中血流感染组188例,中枢神经系统感染组23例,肺部感染组289例,腹腔感染组60例,泌尿系感染组106例;骨关节感染14例;皮肤软组织感染17例;其他感染14例。病原菌类型中肺炎克雷伯菌127例,大肠埃希菌121例,凝固酶阴性葡萄球菌69例,鲍曼不动杆菌65例,金黄色葡萄球菌61例,铜绿假单胞菌54例,屎肠球菌43例,阴沟肠杆菌26例,其他G^(-)菌108例,其他G^(+)菌37例。酶联免疫荧光法检测PCT。结果:不同感染部位患者PCT水平不同,以血流感染、腹腔感染的水平最高,较其他部位感染差异均有统计学意义(P<0.001)。在不同病原菌的感染中,PCT水平由高到低分别为大肠埃希菌、阴沟肠杆菌、肺炎克雷伯菌,G^(-)菌感染水平较G^(+)菌高,差异均有统计学意义(P<0.001)。结论:PCT检测在人体感染部位水平有差异,血流感染和腹腔感染PCT值较高,G^(-)菌PCT水平较G^(+)菌高,大肠埃希菌、阴沟肠杆菌PCT水平较其他G^(-)菌高。监测血清PCT对明确感染部位和可能的致病菌提供参考,以指导临床抗菌药物的使用。

Objective:To investigate the application value of serum procalcitonin in human infection characteristics and pathogen species.Method:Among the hospitalized infected patients from February 2019 to February 2020,711 patients were selected for both etiological examination and PCT detection,188 patients were in the bloodstream infection group,23 patients were in the central nervous system infection group,289 patients were in the respiratory system infection group,60 patients were in the abdominal infection group,106 patients were in the urinary system infection group,14 cases of osteoarticular infection,17 cases of skin and soft tissue infection and 14 cases of other infections.Among the pathogenic bacteria types,there were 127 cases of Klebsiella Pneumoniae,121 cases of Escherichia Coli,69 cases of Coagulase-negative Staphylococcus,65 cases of Acinetobacter Baumannii,61 cases of Staphylococcus Aureus,54 cases of Pseudomonas Aeruginosa,43 cases of Enterococcus Feces,26 cases of Enterobacter Cloacae,108 cases of other Gram-negative bacteria and 37 cases of other Gram-positive bacteria.PCT was detected by enzyme-linked immunoassay(MEIA).Result:The level of PCT in patients with different infection sites was different,the level of bloodstream infection and abdominal infection was the highest,compared with that in other sites,which was statistically significant(P<0.001).In the infection of different pathogenic bacteria,the level of PCT was from high to low,which were Escherichia Coli,Enterobacter Cloacae,Klebsiella Pneumoniae,and the infection level of G^(-)bacteria was higher than that of G^(+)bacteria,which was statistically significant(P<0.001).Conclusion:PCT detection showed different levels in the infected site of human body,and the PCT values of bloodstream infection and abdominal infection were higher,the PCT level of Gram-negative bacteria was higher than that of gram-positive bacteria,and the PCT level of Escherichia Coli and Enterobacter Cloacae was higher than that of other G^(-)bacteria.Monitoring serum PCT can provide reference for identifying the infection site and possible pathogenic bacteria to guide the use of clinical antibacterial agents.