Distribution of pathogenic bacteria and the diagnostic value of PCT,ET,NLR and TM combined detection in infection after PICC in patients with acute leukemia
OBJECTIVE To investigate the pathogenic bacteria distribution,drug sensitivity of infection after under-went peripherelly inserted central cateter(PICC)in patients with acute leukemia,and to evaluate the clinical guid-ance value of combined detection of serum procalcitonin(PCT),endotoxins(ET),peripheral blood neutrophil/lymphocyte ratio(NLR)and plasma thrombomodulin(TM).METHODS The clinical data of 152 patients with a-cute leukemia PICC placement admitted to Qingdao Hiser Hospital Affiliated of Qingdao University(Qingdao Tra-ditional Chinese Medicine Hospital)from Aug 2020 to Aug 2023 were retrospectively analyzed,and divided into the infection group(26 cases)and the non-infection group(126 cases)according to whether the infection occurred.The distribution of pathogenic bateria of PICC cannula infection and drug sensitivity of the main causative organ-isms were analyzed.The clinical data,levels of serum PCT,ET,peripheral blood NLR and plasma TM in the in-fected group and non-infected group were compared.The diagnostic value of serum levels of PCT,ET,peripheral blood NLR and plasma TM single and combined detection for the diagnosis of PICC placement infections in pa-tients with acute leukemia were analyzed by receiver operating characteristic curve(ROC)analysis.RESULTS A total of 34 strains were isolated from 26 acute leukemia patients with PICC infection,including 23 strains of gram-negative bacteria(67.65％),10 strains of gram-positive bacteria(29.41％),one strain of fungus(2.94％).The levels of serum PCT,ET,peripheral blood NLR and plasma TM in the infection group were higher than those in the non-infection group(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of combined detection of serum PCT,ET,NLR and TM was 0.931,which was higher than that of single detection(P＜0.05).CONCLUSION The pathogenic bacteria of PICC catheterization infection in patients with acute leukemia were mainly gram-negative bacteria,and different pathogens have different characteristics of drug-resistance to an-tibiotics.The occurrence of the infection were related to the history of underlying diseases,catheter insertion time,chemotherapy times,puncture times and serum PCT,ET,peripheral blood NLR and plasma TM levels.The di-agnostic value of serum PCT,ET,peripheral blood NLR and plasma TM combined detection is higher.
Acute leukemiaPeripherelly inserted central cateterInfectionPathogenic bacteriaResults of drug sensitivityProcalcitoninEndotoxinsNeutrophil/lymphocyte ratioThrombomodulin
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