摘要
目的:探讨血清降钙素原(PCT)检测在区分血流感染主要病原菌种类中的作用,为临床早期选择抗菌药物提供依据。方法:收集2017年11月—2019年12月我院收治的274例血培养阳性(单一菌)患者临床资料,检测其血清PCT水平,并分析革兰阴性(G-)菌、革兰阳性(G^+)菌和真菌之间PCT水平及PCT阳性率差异。结果:274例血培养阳性标本中,G-菌142例,占52.01%(142/274);G^+菌87例,占31.50%(87/274);真菌45例,占16.48%(45/274)。G-菌组、G^+菌组和真菌组血清PCT检测水平差异有统计学意义(H=43.722,P<0.05)。274例血流感染患者血清PCT检测总阳性率为71.53%(196/274),G-菌组、G^+菌组及真菌组感染患者血清PCT检测阳性率差异有统计学意义(χ^2=19.098,P<0.05)。G-菌组、G^+菌组和真菌组血清PCT分组情况差异有统计学意义(χ^2=33.404,P<0.05)。在G-菌中,肺炎克雷伯菌的PCT检测水平和阳性率均高于鲍曼不动杆菌,差异有统计学意义(P<0.05),铜绿假单胞菌的PCT阳性率高于鲍曼不动杆菌,差异有统计学意义(P<0.05)。结论:血清PCT检测对血流感染患者病原菌类型有一定的提示意义,应与血培养联合应用,为临床早期合理选择抗菌药物治疗提供依据。
Objective To explore the role of serum procalcitonin(PCT)in distinguishing different types of pathogens of bloodstream infections,so as to provide guidance for early clinical selection of antibacterial drugs.Methods The clinical data of 274 patients with positive blood culture(single bacteria)from November 2017 to December 2019 were collected.The serum PCT levels were detected and the different levels of PCT from three groups including gram-positive(G^-)bacteria,gram-negtive(G^+)bacteria and fungi groups as well as different pathogens were analyzed.Results Among the 274 blood culture positive specimens,142 cases[52.01%(142/274)]were G^-bacteria,87 cases[31.50%(87/274)]were G^+bacterial infection,and 45 cases[16.48%(45/274)]were fungi infection.There were statistical significance in the difference of PCT levels among the G^-bacterium group,the G^+bacteria group and the fungi group(H=43.722,P<0.05).The total PCT positive rate of the 274 patients with bloodstream infection was 71.53%(196/274).There were statistical significance in the difference of PCT positive rate among the G^-bacterium group,the G^+bacteria group and the fungi group(χ^2=19.098,P<0.05).There were statistical significance in the difference of PCT grouping among Gbacterium group,G^+bacteria group and fungi group(χ^2=33.404,P<0.05).Among the G^-bacteria,the PCT detection level and positive rate of Klebsiella pneumoniae was significantly higher campared to Acinetobacter baumannii(P<0.05).The PCT positive rate of Pseudomonas aeruginosa was significantly higher compared to Acinetobacter baumannii(P<0.05).Conclusion Serum PCT detection has certain hints in distinguishing different types of pathogens of bloodstream infections.Serum PCT detection combined with blood culture can provide a basis for the rational selection of antibacterial drugs in the early clinical stage.
作者
薛海玲
曾昭伟
孙兰菊
和玉淼
常艳敏
XUE Hai-ling;ZENG Zhao-wei;SUN Lan-ju(Department of Clinical Laboratory,Tianjin Nankai Hospital,Tianjin(300100),China)
出处
《中国中西医结合外科杂志》
CAS
2020年第6期1031-1036,共6页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
关键词
降钙素原
血流感染
病原菌
革兰阴性菌
革兰阳性菌
Procalcitonin
bloodstream infection
pathogen
Gram-negative bacteria
Grampositive bacteria
