卒中相关性肺炎患者感染病原菌种类及其与血清cf-DNA/NETs的相关性  

Characteristics of pathogens in patients with stroke-associated pneumonia and their correlation with serum cf-DNA/NETs

作　　者：颜博[1] 岳宗伟 李华坚 黄优[1] 高唯一 王改青 YAN Bo;YUE Zong-wei;LI Hua-jian;HUANG You;GAO Wei-yi;WANG Gai-qing(Department of Neurulugy,Hainan Third People’s Hospital,Haikou 572000,Hainan,China;Department of Neurology,Second Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510235,Guangdong,China)

机构地区：[1]海南省第三人民医院神经内科,海南海口572000 [2]中山大学附属第二医院神经内科,广东广州510235

出　　处：《中国病原生物学杂志》2021年第8期937-939,946,共4页Journal of Pathogen Biology

摘　　要：目的分析卒中相关性肺炎(SAP)的病原学特点,以及患者血清游离DNA/中性粒细胞胞外诱捕网(cf-DNA/NETs)水平与痰培养结果的相关性。方法本院2018年6月-2020年6月收治的SAP患者78例,采集痰液标本进行病原菌培养。于抗生素治疗前采集患者血清标本,检测cf-DNA/NETs水平,分析其与病原学检查结果及预后的相关性。结果 78例SAP患者痰液标本共培养出9种病原菌,共156株,其中革兰阴性菌占78.85%,革兰阳性菌占19.23%,真菌占1.92%。SAP主要致病菌为肺炎克雷伯菌,占53.85%。78例患者中细菌感染75例,真菌感染3例。SAP患者血清cf-DNA/NETs水平显著高于对照组(P<0.05),SAP细菌感染组显著高于真菌感染组(P<0.05)。78例SAP患者中因感染控制不良死亡10例,死亡患者血清cf-DNA/NETs水平显著高于存活患者(P<0.05)。结论 SAP主要为细菌性感染,少数为真菌性感染。血清cf-DNA/NETs对鉴别致病菌类型和患者预后评估有一定参考价值。Objective To analyze the characteristics of pathogens in patients with stroke-associated pneumonia(SAP) and to analyze the correlation between cell-free DNA/neutrophil extracellular traps(cf-DNA/NETs) and sputum culture results. Methods Subjects were 78 patients with SAP seen at this Hospital from June 2018 to June 2020. Prior to antibiotic treatment, deep airway secretions were collected using sterile containers, and peripheral venous blood was also collected. Pathogens were cultured, and cf-DNA/NET levels were measured. The correlation between cf-DNA/NET levels and pathology results and prognosis was analyzed. Results In total, 156 strains of 9 types of pathogens were cultured from 78 sputum samples from 78 patients with SAP. Sputum culture results indicated that Gram-negative bacteria accounted for the largest proportion of pathogens(78.85%), followed by Gram-positive bacteria(19.23%) and fungi(1.92%). The main pathogen responsible for SAP was Klebsiella pneumoniae, which accounted for 53.85% of cases. Of the 78 patients, 75 had a bacterial infection and 3 had a fungal infection. The serum cf-DNA/NET level was 51.15%±13.46% in patients with SAP, which was significantly higher than that(0.29%±0.05%) in healthy controls(t=20.636, P<0.01). The serum cf-DNA/NET level was 52.89%±12.54% in patients with SAP and a bacterial infection, which was significantly higher than that(7.78%±1.73%) in patients with a fungal infection(t=6.190, P<0.01). Of the 78 patients with SAP, 10 died due to poor infection control. Serum cf-DNA/NET levels in the dead were significantly higher than those in survivors(67.84%±12.36% vs. 48.66%±10.62%, t=5.224, P<0.01). Conclusion SAP was mainly caused by a bacterial infection, though it was also caused by a fungal infection in a few cases. Serum cf-DNA/NET levels have a certain value in identifying types of pathogen and predicting patient prognosis.

关 键 词：卒中相关性肺炎 病原学培养 血清游离DNA/中性粒细胞胞外诱捕网 相关性分析 

分 类 号：R378[医药卫生—病原生物学]