降钙素原诊断多重耐药菌血流感染的价值分析  

Analysis on Value of Procalcitonin in Diagnosing Multidrug Resistant Bacterial Bloodstream Infections

作　　者：魏云 冯桂梅[1] 唐翎[2] 王曙光[1] 于勇文 Wei Yun;Feng Guimei;Tang Ling;Wang Shuguang;Yu Yongwen(Department of Pharmacy,Hunan Aerospace Hospital,Changsha 410205,Hunan Province,China;Department of Pharmacy,Xiangya Hospital of Central South University,Changsha 410008,Hunan Province,China)

机构地区：[1]湖南航天医院药剂科,湖南长沙410205 [2]中南大学湘雅医院药学部,湖南长沙410008

出　　处：《中国社区医师》2024年第28期92-94,共3页Chinese Community Doctors

基　　金：中国航天科工集团航天医科项目(编号:2020YK15)。

摘　　要：目的:探讨降钙素原(PCT)诊断多重耐药菌血流感染的价值。方法:选取2020年1月—2023年12月湖南航天医院收治的多重耐药菌血流感染患者360例作为研究对象,均进行血培养和血清PCT水平检测,统计多重耐药菌血流感染患者病原菌及PCT阳性情况,比较不同病原菌血流感染患者血清PCT水平,并绘制受试者操作特征(ROC)曲线,计算曲线下面积(AUC),评价血清PCT水平诊断多重耐药菌血流感染的价值。结果:360例多重耐药菌血流感染患者中,革兰阳性菌感染最多;病原菌前3位分别是金黄色葡萄球菌、肺炎克雷伯菌、肺炎链球菌;革兰阳性菌感染患者血清PCT阳性率为57.26%,革兰阴性菌感染患者血清PCT阳性率为74.00%,真菌感染患者血清PCT阳性率为38.46%。不同病原菌血流感染患者血清PCT水平比较,革兰阴性菌感染>革兰阳性菌感染>真菌感染,差异有统计学意义(P<0.05)。血清PCT水平对多重耐药菌血流感染有一定诊断价值(AUC=0.695)。结论:多重耐药菌血流感染以革兰阳性菌感染较多,不同病原菌感染患者血清PCT水平不同,血清PCT水平对多重耐药菌血流感染有一定诊断价值。Objective:To explore the value of procalcitonin(PCT)in the diagnosis of multidrug-resistant bacterial bloodstream in⁃fections.Methods:A total of 360 patients with multidrug-resistant bacterial bloodstream infections admitted to Hunan Aerospace Hospital from January 2020 to December 2023 were selected as the study subjects.All patients underwent blood culture and test⁃ing of serum PCT levels.The pathogenic bacteria and PCT positivity of patients with multidrug-resistant bacterial bloodstream in⁃fections were counted.Serum PCT levels of patients with bloodstream infections due to different pathogenic bacteria were com⁃pared.The receiver operating characteristic(ROC)curves were plotted and the area under the curve(AUC)was calculated.The value of serum PCT levels in diagnosing multidrug-resistant bacterial bloodstream infections was evaluated.Results:Among 360 patients with multidrug-resistant bacterial bloodstream infections,Gram-positive bacteria were the most commonly infected.The top three pathogenic bacteria were Staphylococcus aureus,Klebsiella pneumoniae and Streptococcus pneumoniae.The positive rates of serum PCT were 57.26%in patients with Gram-positive bacteria infection,74.00%in patients with Gram-negative bacte⁃ria infection,and 38.46%in patients with fungal infection.The serum PCT levels of patients with bloodstream infections due to dif⁃ferent pathogenic bacteria were compared and ranked as follows:Gram-negative bacteria infection>Gram-positive bacteria infec⁃tion>fungal infection,and there was a statistically significant difference(P<0.05).Serum PCT level had a certain diagnostic value for multidrug-resistant bacterial bloodstream infections(AUC=0.695).Conclusion:Multidrug-resistant bacterial bloodstream in⁃fections are mainly Gram-positive bacteria infection.Serum PCT levels in patients infected with different pathogenic bacteria are different.Serum PCT level has a certain diagnostic value for multidrug-resistant bacterial bloodstream infections.

关 键 词：降钙素原 多重耐药菌 血流感染 抗菌药物 

分 类 号：R446.5[医药卫生—诊断学]