PCT、CRP、SAA和WBC联合检测结合细菌培养对鲍曼不动杆菌感染的诊断价值  

Diagnostic value of procalcitonin,C-reactive protein,serum amyloid A and white blood cell count combined with bacterial culture for Acinetobacter baumannii infection

作　　者：黄玲玲[1] 赵晓飞[1] 辛晓阳 陈益明 HUANG Ling-ling;ZHAO Xiao-fei;XIN Xiao-yang;CHEN Yi-ming(Department of Clinical Laboratory,Affiliated Hospital of Hangzhou Normal University,Hangzhou,Zhejiang 310015,China;不详)

机构地区：[1]杭州师范大学附属医院检验科,浙江杭州310015 [2]杭州市妇产科医院产前筛查实验室

出　　处：《中国卫生检验杂志》2022年第23期2873-2878,共6页Chinese Journal of Health Laboratory Technology

摘　　要：目的 了解降钙素原(PCT)、C-反应蛋白(CRP)、血清淀粉样蛋白A(SAA)联合白细胞计数(WBC)检测结合细菌培养对鲍曼不动杆菌(Acinetobacterbaumannii,AB)感染的诊断价值。方法 采用回顾性病例对照研究方法,分析2020年1月—2021年12月医院临床各科送检后分离到的AB,根据有无AB感染将研究对象分为疾病组(323例)和对照组(104例),比较两组血液中PCT、CRP、SAA和WBC的检测结果,用受试者工作特征(ROC)曲线确定曲线下面积(AUC),评价对AB感染的诊断价值。结果 疾病组PCT、CRP、SAA均高于对照组(P<0.05),2组WBC水平差异无统计学意义(P>0.05)。ROC曲线结果显示,单种标志物对AB感染诊断价值较高的有PCT、CRP和SAA,其AUC分别为0.673、0.670和0.612;联合多种标志物对AB感染有较高诊断价值的有PCT+CRP、PCT+CRP+SAA+BT、PCT+CRP+SAA、PCT+CRP+BT和PCT+CRP+SAA+BT+L,其AUC分别为0.693、0.691、0.690、0.688和0.681。AB对头孢唑啉、头孢曲松、头孢替坦、呋喃妥因、氨曲南和氨苄西林耐药率较高。结论 AB感染者对抗生素耐药现象依然严峻,尤其是头孢类抗生素和呋喃妥因,通过血液PCT、CRP、SAA和联合WBC检测结合细菌培养,可以提高AB的诊断价值。Objective The aim of this study is to evaluate the diagnostic value of serum procalcitonin(PCT), C-reactive protein(CRP), serum amyloid A(SAA), white blood cell count(WBC) combined with bacterial culture for Acinetobacter baumannii(AB) infection. Methods A retrospective case-control study method was used to analyze the AB isolates sent by clinical departments from January 2020 to December 2021. According to the presence or absence of AB infection, the research subjects were divided into case group(n=323) and control group(n=104). The results of PCT, CRP, SAA and WBC were compared between the two groups, and the area under curve(AUC) was determined by receiver operating characteristic(ROC) curve to evaluate the diagnostic value of AB infection. Results PCT, CRP and SAA in the disease group were higher than those in the control group(P<0.05), and there was no statistical significance on the difference in WBC level between the two groups(P>0.05). The results of the ROC curve showed that single markers of high diagnostic value for AB. infection were PCT, CRP and SAA and their AUCs were 0.673, 0.670 and 0.612, respectively;combined markers with high diagnostic value for A. b. infection were PCT + CRP, PCT + CRP + SAA + BT, PCT + CRP+ SAA, PCT + CRP + BT and PCT + CRP + SAA + BT + L,and their AUCs were 0.693, 0.691, 0.690, 0.688 and 0.681, respectively. The resistance rate of AB to cefazolin, ceftriaxone, cefotetan, nitrofurantoin, aztreonam and ampicillin was high. Conclusion Therefore, AB is seriously resistant to antibiotics, especially cephalosporins and furantoin. By the detection of PCT, CRP, SAA and WBC combined with bacterial culture, the diagnostic value for AB can be improved.

关 键 词：降钙素原 C-反应蛋白 血清淀粉样蛋白A 白细胞计数 鲍曼不动杆菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]