TTP联合炎症指标鉴别肿瘤患者CoNS血流感染与污染  

TTP combined with inflammatory indicators identifies CoNS bloodstream infection and contamination in tumor patients

作　　者：杨晓芳[1] 张颖 张曦 杨伟[1] YANG Xiaofang;ZHANG Ying;ZHANG Xi;YANG Wei(Department of Clinical Laboratory,Yunnan Cancer Hospital,Kunming,Yunnan 650118,China)

机构地区：[1]云南省肿瘤医院检验科,云南昆明650118

出　　处：《国际检验医学杂志》2025年第3期303-307,共5页International Journal of Laboratory Medicine

摘　　要：目的 探讨阳性报警时间(TTP)联合炎症指标鉴别肿瘤患者凝固酶阴性葡萄球菌(CoNS)血流感染与污染的价值。方法 回顾性分析该院2022年9月至2023年4月收治的368例血培养阳性肿瘤患者,筛选出其中血培养CoNS阳性且临床资料完整的47例患者作为研究对象,根据血流感染诊断标准并结合患者的临床表现及实验室检查结果将其分为CoNS感染组(24例)和CoNS污染组(23例)。另选取同期该院收治的血培养金黄色葡萄球菌阳性肿瘤患者5例作为对照组。比较各组TTP、未成熟粒细胞百分率(IG%)、未成熟粒细胞绝对值(IG#)、白细胞计数(WBC)、中性粒细胞百分比(NE%)、中性粒细胞/淋巴细胞比值(NLR)、C反应蛋白(CRP)和降钙素原(PCT)水平。结果 47例患者血培养CoNS菌株中以人葡萄球菌最为常见(42.55%)。CoNS感染组、CoNS污染组和对照组TTP、NE%、NLR和CRP水平比较,差异有统计学意义(P<0.05)。CoNS感染组TTP短于CoNS污染组,NE%、NLR、CRP、PCT水平均高于CoNS污染组,差异有统计学意义(P<0.05)。TTP联合NLR、CRP和PCT的曲线下面积最大,为0.971(P<0.000 1),灵敏度为91.67%,特异度为95.65%、似然比为21.08、阳性预测值为91.67%、阴性预测值为95.65%,准确度为93.62%。结论 TTP联合NLR、CRP和PCT对肿瘤患者CoNS血流感染与污染的鉴别诊断具有重要的临床价值。Objective To explore the value of the time to positivity(TTP)combined with inflammatory indicators for identifying coagulase-negative Staphylococcus(CoNS)bloodstream infection and contamination in tumor patients.Methods A retrospective analysis was performed on totally 368 tumor patients with blood culture-positive admitted to the hospital from September 2022 to April 2023,and 47 patients with blood culture-positive CoNS and complete clinical data were selected as research objects.The patients were divided into CoNS infection group(24 cases)and CoNS contamination group(23 cases)according to the diagnostic criteria of bloodstream infection and in combination with the clinical manifestations and laboratory examination results.In addition,5 tumor patients with blood culture Staphylococcus aureus positive admitted to the hospital during the same period were selected as the control group.The TTP,percentage of immature granulocytes(IG%),absolute value of immature granulocytes(IG#),white blood cell count(WBC),neutrophil percentage(NE%),neutrophil-to-lymphocyte ratio(NLR),C-reactive protein(CRP)and procalcitonin(PCT)levels in all groups were compared.Results Among the 47 patient isolates of CoNS from blood cultures,Staphylococcus hominis was the most common,accounting for 42.55%.There were significant differences in TTP,NE%,NLR and CRP levels between CoNS infection group,CoNS contamination group and control group(P<0.05).The TTP in CoNS infection group was shorter than that in CoNS contamination group,and the levels of NE%,NLR,CRP and PCT were higher than those in CoNS contamination group,with statistical significance(P<0.05).TTP combined with NLR,CRP and PCT had the largest area under the curve,which was 0.971(P<0.0001),with a sensitivity of 91.67%,specificity of 95.65%,likelihood ratio of 21.08,positive predictive value of 91.67%,negative predictive value of 95.65%,and an accuracy of 93.62%.Conclusion TTP combined with NLR,CRP and PCT have important clinical value in the differential diagnosis of CoNS bloodstream infec

关 键 词：阳性报警时间 凝固酶阴性葡萄球菌 肿瘤 血流感染 

分 类 号：R730.4[医药卫生—肿瘤]