Study on the expression levels of NLRP3,CRP/ALB,IL?6 and prognostic factors in carbapenem?resistant Klebsiella pneumoniae infection
Objective To analyze the expression levels of nucleotide⁃binding oligomeric domain⁃like receptor protein 3(NLRP3),C⁃reactive protein/albumin(CRP/ALB)and interleukin⁃6(IL⁃6)in carbap⁃enem⁃resistant Klebsiella pneumoniae infection and the factors related to prognosis.Methods A total of 294 patients with carbapenem⁃resistant Klebsiella pneumoniae infection were admitted to Zhongjiang County People's Hospital,Chengdu Second People's Hospital,and Deyang People's Hospital from January 2022 to June 2023.They were divided into two groups based on their prognosis:the poor prognosis group(51 patients)and the good prognosis group(243 patients).The prognostic factors in patients with carbapenem⁃resistant Klebsiella pneumoniae infection were analyzed using both univariate and multivariate methods.Additionally,the expres⁃sion levels of NLRP3,CRP/ALB,and IL⁃6 were compared between patients with different prognoses.Receiver operating characteristic(ROC)curves were plotted to analyze the predictive value of NLRP3,CRP/ALB and IL⁃6 individually and in combination for carbapenem⁃resistant Klebsiella pneumoniae infection.Results The proportion of patients in the poor prognosis group was higher than that in the good prognosis group in terms of age,severity,deep venous catheter use,diabetes,multiple organ failure,use of vasoactive drugs,sedative drugs and cardiac drugs(P<0.05).Multivariate logistic analysis showed that severe disease severity,deep ve⁃nous catheterization,multiple organ failure and use of vasoactive drugs were risk factors for poor prognosis in carbapenem⁃resistant Klebsiella pneumoniae infection(P<0.05).Compared to the good prognosis group,the levels of serum NLRP3,CRP/ALB,and IL⁃6 in the poor prognosis group were higher(P<0.05).ROC curve analysis of NLRP3,CRP/ALB and IL⁃6 combined detection for carbapenem⁃resistant Klebsiella pneumoniae in⁃fection had the highest predictive value for poor prognosis,with an area under the curve(AUC)of 0.910,sensi⁃tivity of 86.27％and specificity of 87.24％.Conclusion Patients with carbapenem⁃resistant Klebsiella pneu⁃moniae infections are at risk of a poor prognosis.There are many risk factors involved,and the combined detec⁃tion of NLRP3,CRP/ALB,and IL⁃6 has a high predictive value.
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