Etiological characteristics of multidrug-resistant organisms infections in patients with severe pneumonia and diagnostic values of NETs,IL-17 and TGF-β
OBJECTIVE To investigate the etiological characteristics,drug resistance,and diagnostic value of neu-trophil extracellular reticular trap(NETs),interleukin-17(IL-17)and transforming growth factor-β(TGF-β)in patients with severe pneumonia(SP)with multi-drug resistant bacteria(MDRO).METHODS The clinical data of 176 patients with SP admitted to Sichuan Provincial People's Hospital from Jun 2019 to Mar 2023 were retrospec-tively analyzed.The selected patients were divided into the uninfected group(102 cases)and infected group(74 ca-ses)according to whether they had multidrug-resistant bacteria infection.The pathogenic characteristics in the in-fection group were analyzed,and clinical data,NETs,IL-17 and TGF-β were compared between the two groups.The diagnostic value of NETs,IL-17 and TGF-β in MDRO infection in patients with SP was analyzed by receiver operating characteristic(ROC)curve.RESULTS Among the 74 infected patients,98 MDRO were isola-ted,gram-positive bacteria accounting for 34.69％and gram-negative bacteria accounting for 65.31％.The pro-portion of patients with nosocomial pneumonia,invasive mechanical ventilation,carbapenem use,and three or more combined antibacterial agents use in the infected group were higher than that in the uninfected group(P＜0.05).The levels of serum NETs and IL-17 in the infection group were higher than those in the uninfected group,while the level of serum TGF-β were lower than that in the uninfected group(P＜0.05).The area under curve(AUC)of NETs,IL-17,TGF-β individual and combined detection for the diagnosis of MDRO infection in patients with SP were 0.629,0.684,0.649 and 0.886,respectively,with the sensitivity of 64.86％,66.22％,62.16％and 79.73％,respectively.The specificity were 66.67％,66.67％,68.63％and 89.22％,respectively,and the AUC,sensitivity and specificity of combined detection were the highest(P＜0.05).CONCLUSION The propor-tion of Acinetobacter baumannii,Pseudomonas aeruginosa,and Klebsiella pneumoniae of MDRO strains in SP patients is relatively high.Risk factors of MDRO infection are patient disease type,invasive mechanical ventila-tion,carbapenem drug use,and combination of antibiotics,and the changes of levels of serum NETs,IL-17 and TGF-β were closely related to MDRO infection.The combined examination of the three indexes has high diagnostic value,which can provide an effective reference for clinical diagnosis and treatment.Therefore,targeted prevention and antimicrobial therapy could promote the therapeutic effect in clinic.
Severe pneumoniaMultidrug-resistant bacteriaEtiologicalDrug resistanceNeutrophil extracellular reticular trapInterleukin-17Transforming growth factor beta
NETL
NSTL
万方数据
