精神分裂症患者尿路感染病原菌及外周血NLRP3/IL-1β通路表达

Distribution of pathogens isolated from schizophrenia patients with urinary tract infection and expressions of NLRP3/IL-1βpathways in peripheral blood

目的探讨精神分裂症患者尿路感染病原菌及外周血Nod样受体蛋白3(NLRP3)/白细胞介素(IL)-1β通路表达。方法选取2020年1月-2023年1月杭州市第七人民医院收治的602例精神分裂症患者为研究对象,根据是否发生尿路感染分为感染组30例和非感染组572例,分析尿路感染病原菌,并进行药敏试验,比较两组患者外周血NLRP3、核因子κB(NF-κB)、IL-1β表达,三指标单独及联合检测对精神分裂症患者尿路感染的诊断价值。结果30例精神分裂症尿路感染患者,共培养出48株病原菌,主要为革兰阴性菌中的大肠埃希菌和革兰阳性菌中的粪肠球菌,真菌占比较少。大肠埃希菌对哌拉西林、左氧氟沙星耐药严重,对亚胺培南、阿米星卡敏感;粪肠球菌对苯唑西林、红霉素耐药严重,对呋喃妥因、替加环素敏感。感染组外周血NLRP3、NF-κB、IL-1β表达高于非感染组(P<0.05)。外周血NLRP3、NF-κB、IL-1β表达联合检测对精神分裂症患者尿路感染诊断的曲线下面积(AUC)高于单独检测(P<0.05),且联合检测的敏感度为93.33%,特异度为89.32%。结论精神分裂症尿路感染患者主要病原菌为大肠埃希菌和粪肠球菌,大肠埃希菌对亚胺培南、阿米星卡敏感,粪肠球菌对呋喃妥因、替加环素敏感,且NLRP3/IL-1β通路激活,外周血NLRP3、NF-κB、IL-1β联合检测诊断价值高。

OBJECTIVE To explore the distribution of pathogens isolated from the schizophrenia patients with urinary tract infection and analyze the expressions of NOD-like receptor protein 3(NLRP3)/interleukin(IL)-1βin peripheral blood.METHODS A total of 602 patients with schizophrenia who were treated in Hangzhou Seventh People′s Hospital from Jan.2020 to Jan.2023 were recruited as the research subjects and were divided into the infection group with 30 cases and the non-infection group with 572 cases according to the status of urinary tract infection.The distribution of pathogens causing the urinary tract infection were analyzed,the drug susceptibility testing was performed,and the expression levels of peripheral blood NLRP3,nuclear factorκB(NF-κB)and IL-1βwere compared between the two groups of patients.The values of the single and joint detection of the three indexes in diagnosis of urinary tract infection in the schizophrenia patients were analyzed.RESULTS Totally 48 strains of pathogens were isolated from 30 schizophrenia patients with urinary tract infection;the gram-negative bacteria Escherichia coli and gram-positive bacteria Enterococcus faecalis were dominant among the pathogens,while the fungi were less common.The E.coli strains were highly resistant to piperacillin and levofloxacin,while the strains were sensitive to imipenem and amikacin.The E.faecalis strains were highly resistant to oxacillin and erythromycin,while the strains were sensitive to nitrofurantoin and tigecycline.The expression levels of peripheral blood NLRP3,NF-κB and IL-1βof the infection group were higher than those of the non-infection group(P<0.05).The area under curve(AUC)of the joint detection of peripheral blood NLRP3,NF-κB and IL-1βwas higher than that of the single detection in diagnosis of urinary tract infection in the schizophrenia patients(P<0.05),the sensitivity of the joint detection was 93.33%,the specificity 89.32%.CONCLUSIONS E.coli and E.faecalis are the predominant species of pathogens isolated from the schizophrenia patients with urinary tract infection.The E.coli strains are sensitive to imipenem and amikacin.The E.faecalis strains are sensitive to nitrofurantoin and tigecycline.The NLRP3/IL-1βpathways are activated,and the joint detection of peripheral blood NLRP3,NF-κB and IL-1βhas high diagnostic value.