感染性心内膜炎病原菌分布特征及可溶性细胞间黏附分子-1表达水平对革兰阳性球菌感染的预测  

Distribution characteristics of pathogens and expression of soluble intercellular adhesion molecule-1 in patients with infective endocarditis and prediction of Gram-positive cocci infection

作　　者：朱政[1] 王碧倩[1] 徐亚军 熊寒露 ZHU Zheng;WANG Bi-qian;XU Ya-jun;XIONG Han-lu(Department of Critical Care Medicine,Central Hospital of Xinyu Iron and Steel Group Co.,Ltd.,Xinyu,Jiangxi 338000,China)

机构地区：[1]新余钢铁集团有限公司中心医院重症医学科,江西新余338000

出　　处：《中国病原生物学杂志》2021年第8期965-968,共4页Journal of Pathogen Biology

摘　　要：目的探讨感染性心内膜炎(IE)的病原菌分布特征,评价可溶性细胞间黏附分子-1表达水平对IE患者感染革兰阳性球菌的预测价值,分析革兰阳性球菌感染的影响因素。方法 2017年1月-2019年7月本院重症医学科收治的感染性心内膜炎患者82例,根据患者血液细菌培养结果分为革兰阳性球菌阳性组和阴性组。分析感染病原菌的分布特征。取患者血清标本,采用双抗体夹心ELISA检测可溶性细胞间黏附分子-1水平,分析其对革兰阳性球菌感染的预测价值。收集患者临床资料,进行革兰阳性球菌感染的单因素分析和Logistic回归分析。结果 82例感染性心内膜炎患者中血液培养阳性52例,其中革兰阳性菌感染40例,以酿脓链球菌占比较高,其次为金黄色葡萄球菌。经单因素分析,性别、年龄、体质量指数、左心射血分数、左心室缩短分数、左室舒张末径、心脏赘生物、基础性心脏病、C反应蛋白、可溶性细胞间黏附分子-1等参数为革兰阳性球菌感染相关因素(P<0.05或P<0.01);Logistic回归分析显示,基础性心脏病(OR=2.016,95%CI:1.079~3.767)、心脏赘生物(OR=1.835,95%CI:1.206~2.791)、左心射血分数(OR=1.505,95%CI:1.041~2.176)和可溶性细胞间黏附分子-1(OR=2.016,95%CI:1.120~3.629)为革兰阳性球菌感染的独立危险因素(P<0.05或P<0.01)。结论 IE患者感染病原菌以酿脓链球菌和金黄色葡萄球菌为主,基础性心脏病、心脏赘生物和左心射血分数等是IE患者发生革兰阳性球菌感染的独立危险因素,其中可溶性细胞间黏附分子-1对感染的发生有预测价值,可为临床提供参考。Objective To discuss the distribution characteristics of pathogens and expression of soluble intercellular adhesion molecule 1 in patients with infective endocarditis and prediction of a Gram-positive cocci infection. Methods Subjects were 82 patients with infective endocarditis treated in the intensive care unit of this Hospital from January 2017 to July 2019. Subjects were divided into positive group and negative group according to a bacterial culture of blood. The distribution characteristics of pathogenic bacteria were analyzed. Serum samples were collected from patients, and double-antibody sandwich ELISA was used to detect the level of soluble intercellular adhesion molecule 1 to analyze its predictive value in predicting a Gram-positive cocci infection. Clinical data on patients were collected, and univariate analysis and logistic regression analysis of the development of a Gram-positive cocci infection were performed. Results Of the 82 patients with infective endocarditis, 52 had positive blood cultures, so patients tested positive at a rate of 63.41%. Forty of the patients were infected with Gram-positive bacteria, with Streptococcus pyogenes accounting for the largest proportion(57.69%), followed by Staphylococcus aureus(13.46%). According to univariate analysis, sex, age, body mass index, the left ventricular ejection fraction, the left ventricular shortening fraction, the left ventricular end-diastolic diameter, cardiac vegetation, underlying heart disease, the C-reactive protein level, and the soluble intercellular adhesion molecule 1 level were factors related to development of a Gram-positive cocci infection(P<0.05 or P<0.01). Logistic regression analysis indicated that underlying heart disease(OR=2.016, 95% CI: 1.079-3.767), cardiac vegetation(OR=1.835, 95% CI: 1.206-2.791), the left ventricular ejection fraction(OR=1.505, 95% CI: 1.041-2.176), and the soluble intercellular adhesion molecule 1 level(OR=2.016, 95% CI: 1.120-3.629) were independent factors for development of a Gram-positive cocci in

关 键 词：感染性心内膜炎 病原菌分布特征 可溶性细胞间黏附分子-1 影响因素 

分 类 号：R378[医药卫生—病原生物学]