Comparison among inflammatory markers and haematological indexes in predicting and diagnosing urinary tract-related bloodstream infections and analysis of their combined application value
Objective:To explore the predictive diagnostic value of interleukin 6(IL-6),procalcitonin(PCT),white blood cell(WBC),platelet(PLT),neutrophil/lymphocyte ratio(NLR),C-reactive protein(CRP),and CRP+PCT+IL-6 combined detection for urinary tract-related bloodstream infection(UT-BSI).Methods:From No-vember 2021 to November 2023,252 patients with positive urine culture results within 48 hours admitted to Jian-yang City People's Hospital were retrospectively analysed.According to their blood culture results,they were di-vided into two groups.Patients with positive blood culture within 7 days after urine culture who obtained the same microorganisms were included in the experimental group(97 cases),while 155 suspected bloodstream infection patients with negative blood culture results were selected as the control group.The levels of six detection indica-tors,such as IL-6,PCT and etc.were compared between the two groups.Multivariate logistic stepwise regres-sion was used to analyze the risk factors in UT-BSI,and receiver operating characteristic(ROC)curve was used to evaluate the predictive value of the six indicators and the combined detection for UT-BSI.Results:The main pathogens of urinary tract associated bloodstream infection were Gram-negative bacilli,Gram-positive cocci fol-lowed,and fungi were rare.There were statistically significant differences between the experimental group and the control group in six test indexes,such as IL-6,PCT and etc(P＜0.05).Multivariate logistic stepwise regression analysis showed that IL-6,PCT,and CRP were independent risk factors in UT-BSI(P＜0.05).The area under curve(AUC)showed that the single detection of PCT has the highest value(0.915)and the best diagnostic per-formance.The combined detection of IL-6+PCT+CRP has a sensitivity of 93.8％,specificity of 87.7％,Youden index of 0.815,AUC 0.953,and better diagnostic efficacy than single detection.Conclusion:The patho-genic bacteria of UT-BSI are mainly Escherichia coli,followed by Enterococcus faecalis and Klebsiella pneumoni-ae.These six indicators can all serve as powerful supplements for predictive diagnosis of blood flow infections in patients with urinary tract infections.IL-6,PCT,and CRP are independent risk factors in UT-BSI,while WBC,PLT,and NLR have limited diagnostic value.Among six detection indicators,PCT is superior to IL-6 and CRP in the comprehensive diagnostic performance of UT-BSI.The combined detection of IL-6+PCT+CRP can improve its diagnostic accuracy,which is helpful for the early diagnosis and monitoring of UT-BSI in clinical practice.
urinary tract-related bloodstream infectioninterleukin-6procalcitoninwhite blood cellsplate-letsneutrophil/lymphocyte ratioC-reactive proteinpredictive value
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