The diagnostic significance of multiple inflammatory markers in bloodstream infection caused by Burkholderia pseudomallei and other bacterial pathogens
Objective To investigate the diagnostic value of procalcitonin(PCT),serum amyloid A(SAA),hypersensitive C-reactive protein(hs-CRP),white blood cell count(WBC),and neutrophil percentage(NEU％)in differentiating Burkholderia pseudomallei bloodstream infections from other bacterial infections.Methods The test results of 399 patients with positive blood cultures,who were admitted to the Sanya People's Hospital from January 2021 to December 2022 were retrospectively analyzed.According to the results of blood culture,91 patients with Gram-positive(G+)cocci infection were categorized into the G+cocci group,while 265 patients with Gram-negative(G-)bacillus infection were classified into the G-bacillus group.Additionally,43 patients with Burkholderia pseudomallei infection were allocated to the Burkholderia pseudomallei group.The potential differences in inflammatory indicators among different groups were compared.Results The PCT level of the G-bacillus group was significantly higher than that of the G+cocci group and Burkholderia pseudomallei group(H=24.371,P＜0.05).Additionally,the hs-CRP level of the Burkholderia pseudomallei group was significantly higher than that of both the G-bacillus group and G+cocci group(H=16.305,P＜0.05).However,there were no significant differences in SAA levels,WBC counts,and NEU％values(all P＞0.05).When PCT≥0.5 ng/mL,SAA≥ 10 ng/mL,hs-CRP≥5 ng/mL,WBC≥9.15×109/L,and NEU％≥70％;these values would be considered as positive cut-off points.The positive rates of PCT,SAA,and hs-CRP in the G+cocci group were significantly lower than those in the G-bacillus group(x2=23.259,9.877,11.485)and Burkholderia pseudomallei group(x2=6.944,6.803,4.559)(all P＜0.05).The binary logistic regression analysis revealed that PCT,SAA,and hs-CRP exhibited statistical significance in the identification of other G-bacillus and Burkholderia pseudomallei(all P＜0.05).Conclusions PCT had a certain diagnostic value in distinguishing G-bacillus and G+cocci bloodstream infections.The hs-CRP level had a diagnostic significance for distinguishing Burkholderia pseudomallei from bloodstream infections caused by other bacterial pathogens.Combining the detection of multiple inflammatory indicators such as PCT,SAA,and hs-CRP could improve the early diagnosis and monitoring of Burkholderia pseudomallei infection.
Indicators of inflammationBurkholderia pseudomalleiBloodstream infectionG+cocciG-bacillus
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NSTL
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