Pathogenic bacteria and expressions of peripheral blood TLR7/IL-23/IL-17 signaling pathways in hip fracture patients with postoperative new-onset pulmonary infection
OBJECTIVE To explore the pathogenic bacteria and expressions of peripheral blood Toll-like receptor 7/interleukin-23/interleukin-17(TLR7/IL-23/IL-17)signaling pathways in the hip fracture patients with postopera-tive new-onset infection.METHODS A total of 394 patients with hip fracture who were treated in Chengdu Shuangnan Hospital from Jan 2019 to Jan 2023 were enrolled in the study and were divided into the infection group with 50 cases and the no infection group with 344 cases according to the status of new-onset pulmonary infection,and the clinical data of the enrolled patients were retrospectively analyzed.The distribution of pathogens isolated from the hip fracture patients with postoperative new-onset pulmonary infection was observed,the clinical data and the levels of TLR7/IL-23/IL-17 signaling pathway-related indexes were compared between the infection group and the no infection group.The values of peripheral blood mononuclear cells(PBMCs)TLR7,serum IL-23,IL-17 and IL-6 in diagnosis of the postoperative new-onset pulmonary infection were analyzed.RESULTS Totally 53 strains of pathogens were isolated from the 50 hip fracture patients with postoperative new-onset pulmonary infec-tion,34(64.15％)of which were gram-negative bacteria.The percentages of patients complicated with diabetes mellitus,hypoproteinemia,TLR level,serum IL-23 level,IL-17 level and IL-6 level were higher in the infection group than in the no infection group(P＜0.05).Receiver operating characteristic(ROC)curve analysis showed that the area under curve(AUC)of the joint detection of TLR7,serum IL-23,IL-17 and IL-6 was 0.926 in diag-nosis of the postoperative new-onset pulmonary infection in the hip fracture patients,higher than that of the single detection of TLR7,serum IL-23,IL-17 and IL-6(P＜0.05).CONCLUSION The gram-negative bacteria are domi-nant among the pathogens isolated from the hip fracture patients with postoperative new-onset pulmonary infec-tion,which is associated with the complication with diabetes mellitus and hypoproteinemia.The patients show the high expression levels of PBMCs TLR7,serum IL-23 and IL-17,and the joint detection of the three indexes has higher value in diagnosis of the postoperative new-onset pulmonary infection in the hip fracture patients.
Hip fracturePulmonary infectionPostoperaive infectionPathogenToll-like receptor 7Interleu-kin-23Interluekin-17
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