早产儿中心静脉导管相关血流感染的菌群特征及其相关基因表达变化

Microflora characteristics and related gene changes of PICC induced catheter-relat⁃ed bloodstream infection in premature infants

目的研究早产儿中心静脉导管(PICC)相关血流感染(CRBSI)的菌群特征及其与血清降钙素原(PCT)、可溶性髓系细胞触发受体-1(sTREM-1)等基因表达变化的相关性。方法通过病原学标本检测与基因分析方法,对某医院住院行PICC置管并发生CRBSI的早产患儿感染菌群特征与某些基因变化情况进行研究与分析。结果从55例PICC置管CRBSI早产儿送检病原学标本中共检出病原菌55株,革兰阳性菌占比为36.36%,革兰阴性菌占比为43.64%,真菌占比为20.00%。55例PICC置管CRBSI早产儿血浆PCT和血清sTREM-1水平均高于无CRBSI组的患儿。革兰阳性菌与革兰阴性菌感染CRBSI早产儿血浆PCT水平均高于真菌感染者。结论PICC置管CRBSI早产儿革兰阴性菌和革兰阳性菌感染较高,其血浆PCT和血清sTREM-1水平相对较高,提示早产儿PICC置管CRBSI诊断具有一定的价值。

Objective To investigate the microflora characteristics of peripherally inserted central catheter(PICC)induced catheter-related bloodstream infection(CRBSI)in premature infants and its correlation with the gene expression changes of serum procalcitonin(PCT)and soluble triggering receptor expressed on myeloid cell-1(sTREM-1).Methods Using the methods of pathogenic specimen detection and gene analysis,the microflora characteristics and some gene changes of hospitalized premature infants with PICC induced CRBSI in a hospital were studied and analyzed.Results A total of 55 strains of pathogens were detected from the etiological specimens of 55 premature infants with PICC induced CRB⁃SI,among which gram-positive bacteria accounted for 36.36%,gram-negative bacteria accounted for 43.64%,and fungi accounted for 20.00%.The plasma PCT and serum sTREM-1 levels of 55 CRBSI premature infants with PICC were higher than those of the premature infants without CRBSI.The plasma PCT levels of CRBSI premature infants with gram-positive bacteria and gram-negative bacteria infection were higher than those of the infants with fungal infection.Conclusion CRBSI preterm infants with PICC are highly infected with gram-negative bacteria and gram-positive bacteria,and their plasma PCT and serum sTREM-1 levels are relatively high,suggesting that there is a certain value in the diagnosis of CRBSI premature infants with PICC.