血液透析导管相关性血流感染病原菌及与IL-6基因多态性的关联  

Pathogenic bacteria isolated from hemodialysis patients with catheter-related bloodstream infection and association with IL-6 gene polymorphisms

作　　者：黄忠平 郑芳芳 王洁 韩文丹 钱佳成 HUANG Zhong-ping;ZHENG Fang-fang;WANG Jie;HAN Wen-dan;QIAN Jia-cheng(Huzhou First People's Hospital,Huzhou,Zhejiang 313000,China;不详)

机构地区：[1]湖州市第一人民医院血液透析中心,浙江湖州313000 [2]环渚龙泉街道社区卫生服务中心门诊输液室,浙江湖州313000 [3]湖州市第一人民医院心血管内科,浙江湖州313000

出　　处：《中华医院感染学杂志》2024年第14期2124-2128,共5页Chinese Journal of Nosocomiology

基　　金：浙江省教育厅抗疫专项基金资助项目(Y202043494)。

摘　　要：目的 探究血液透析(HD)导管相关性血流感染(CRBSI)病原菌及与白细胞介素-6(IL-6)基因多态性的关联.方法 选取2020年1月-2023年1月于湖州市第一人民医院行HD治疗的90例发生CRBSI感染患者为感染组,并随机选择同期治疗的61例未发生CRBSI感染患者为未感染组,分析感染组病原菌构成情况,对比两组基线资料,并检测IL-6基因rs1800796位点多态性,比较两组IL-6基因型及等位基因频率分布情况,分析影响HD患者发生CRBSI的危险因素.结果 感染组90例患者中共检出病原菌106株,革兰阳性菌54株、革兰阴性菌49株、真菌3株;感染组IL-6 rs1800796位点CC基因型及C等位基因频率低于未感染组,CG基因型及G等位基因频率高于未感染组(P<0.05);Logistic回归分析显示,置管部位、导管类型、置管时间、透析时间、IL-6 rs1800796位点基因型CG是HD患者CRBSI的危险因素(P<0.05);IL-6基因rs1800796位点携带CG基因型CRBSI感染患者C-反应蛋白(CRP)、降钙素原(PCT)水平高于携带CC、GG基因型患者(P<0.05).结论 IL-6 rs1800796位点基因多态性与HD患者发生CRBSI相关,CG基因型可能属于危险基因,临床可根据基因型情况加强对危险基因群体的保护.OBJECTIVE To explore the pathogenic bacteria isolated from the hemodialysis(HD)patients with cath-eter-related bloodstream infection(CRBSI)and analyze the association with interleukin-6(IL-6)gene polymor-phisms.METHODS A total of 90 HD patients with CRBSI who were treated in Huzhou First People's Hospital form Jan 2020 to Jan 2023 were assigned as the infection group,meanwhile,61 patients who did not have CRBSI were chosen as the no infection group.The distribution of the pathogens isolated from the infection group was ana-lyzed,the baseline data was compared between the two groups,the polymorphisms at rs1800796 locus of IL-6 gene were detected,the frequencies of IL-6 genotypes and alleles were compared between the two groups,and the risk factors for the CRBSI in the HD patients were analyzed.RESULTS Totally 106 strains of pathogens were iso-lated from the 90 patients of the infection group,54 of which were gram-positive bacteria,49 were gram-negative bacteria,and 3 were fungi.The frequencies of CC genotype and C allele at rs1800796 locus of IL-6 were lower in the infection group than in the no infection group,the frequencies of CG genotype and G allele of the infection group were higher than those of the no infection group(P<0.05).Logistic regression analysis showed that intuba-tion site,type of catheter,catheter indwelling time,dialysis time and CG genotype at rs1800796 locus of IL were the risk factors for the CRBSI in the HD patients(P<0.05).The levels of C-reactive protein(CRP)and procalci-tonin(PCT)of the CRBSI patients with CG genotype at rs1800796 locus of IL-6 gene were higher than those of the patients with CC,GG genotypes(P<0.05).CONCLUSION The gene polymorphisms at rs1800796 locus of IL-6 are associated with the CRBSI in the HD patients,and CG genotype may be the risk gene.It is necessary for the hospital to strengthen the protection the population with risk genes according to the genotype.

关 键 词：血液透析 导管相关性血流感染 白细胞介素-6 基因多态性 病原菌 危险因素 关联 

分 类 号：R473[医药卫生—护理学]