急性呼吸窘迫综合征肺部感染病原菌、耐药性及血清ESM-1、sTREM-1和MIP-1α表达  

Distribution and drug resistance of pathogens and expressions of serum ESM-1,sTREM-1 and MIP-1αin acute respiratory distress syndrome patients with pulmonary infection

作　　者：韩虎 张立涛[1] 徐鑫[1] HAN Hu;ZHANG Litao;XU Xin(Hebei Provincial People's Hospital,Shijiazhuang,Hebei 050051,China)

机构地区：[1]河北省人民医院急诊医学科,河北石家庄050051

出　　处：《中华医院感染学杂志》2025年第5期647-651,共5页Chinese Journal of Nosocomiology

基　　金：河北省医学科学研究重点基金资助项目(20230270)。

摘　　要：目的探讨急性呼吸窘迫综合征(ARDS)肺部感染病原菌、耐药性及血清内皮细胞特异性分子-1(ESM-1)、可溶性髓系细胞触发受体1(sTREM-1)及巨噬细胞炎症蛋白-1α(MIP-1α)表达对肺部感染的诊断价值。方法选取2021年10月-2023年10月河北省人民医院收治的98例ARDS合并肺部感染患者为感染组,102例ARDS未发生肺部感染患者为非感染组,分析病原菌分布及耐药性,比较两组血清ESM-1、sTREM-1和MIP-1α水平,分析三指标对ARDS患者合并肺部感染的诊断价值。结果感染组培养出112株病原菌,主要为肺炎克雷伯菌、金黄色葡萄球菌。肺炎克雷伯菌对头孢曲松、头孢唑林耐药率较高分别为56.52%和52.17%;金黄色葡萄球菌对磺胺甲噁唑/甲氧苄啶、克林霉素和苯唑西林耐药率较高,分别为75.00%、75.00%和70.00%。血清ESM-1、sTREM-1、MIP-1α水平感染组和非感染组比较,差异有统计学意义(P<0.05),三指标联合检测对ARDS合并肺部感染患者的曲线下面积(AUC)值高于单独检测(P<0.05),且联合检测的敏感度为93.88%,特异度为84.31%。结论ARDS合并肺部感染患者主要病原菌为肺炎克雷伯菌和金黄色葡萄球菌,患者血清ESM-1、sTREM-1和MIP-1α水平呈高表达,且三指标联合检测对ARDS合并肺部感染诊断价值高。OBJECTIVE To explore the distribution and pathogens isolated from the acute respiratory distress syndrome(ARDS)patients with pulmonary infection and analyze the values of serum endothelial cell-specific molecule-1(ESM-1),soluble triggering receptor expressed on myeloid cells-1(sTREM-1)and macrophage inflammatory protein-1α(MIP-1α)in diagnosis of pulmonary infection.METHODS A total of 98 ARDS patients complicated with pulmonary infection who were treated in Hebei Provincial People′s Hospital from Oct.2021 to Oct.2023 were assigned to the infection group,and 102 ARDS patients who were not complicated with pulmonary infection were chosen as the non-infection group.The distribution and drug resistance of the pathogens were analyzed.The levels of serum ESM-1,sTREM-1 and MIP-1αwere compared between the two groups,and the values of the three indexes in diagnosis of pulmonary infection in the ARDS patients were analyzed.RESULTS Totally 112 strains of pathogens were isolated from the patients of the infection group,among which Klebsiella pneumoniae and Staphylococcus aureus were dominant.The drug resistance rates of K.pneumoniae strains to ceftriaxone and cefazolin were 56.52%and 52.17%,respectively;the drug resistance rates of the S.aureus strains to sulfamethoxazole-trimethoprim,clindamycin and oxacillin were 75.00%,75.00%and 70.00%,respectively.The levels of serum ESM-1,sTREM-1 and MIP-1αof the infection group were higher than those of the non-infection group(P<0.05);the area under the curve(AUC)value of the joint detection of the three indexes was higher than that of the single detection in diagnosis of the pulmonary infection in the ARDS patients(P<0.05),and the sensitivity of the joint detection was 93.88%,with the specificity 84.31%.CONCLUSIONS K.pneumoniae and S.aureus are the predominant species of pathogens isolated from the ARDS patients complicated with pulmonary infection.The patients show the high expressions of serum ESM-1,sTREM-1 and MIP-1α.The joint detection of the three indexes has high value in

关 键 词：急性呼吸窘迫综合征 病原菌 肺部感染 耐药性 内皮细胞特异性分子-1 巨噬细胞炎症蛋白-1Α 可溶性髓系细胞触发受体1 

分 类 号：R563.8[医药卫生—呼吸系统]