Pathogenic bacteria and influencing factors for pulmonary infection in chronic renal failure patients undergoing maintenance hemodialysis
OBJECTIVE To analyze the characteristics of pathogenic bacteria,influencing factors and changes of Toll-like receptor 4(TLR4)/nuclear factor κB(NF-κB)signaling pathway in patients with chronic renal failure and maintenance hemodialysis(MHD).METHODS A total of 350 patients with chronic renal failure MHD admit-ted to the First Affiliated Hospital of Nanyang Medical College from Jan 2018 to Jul 2022 were prospectively in-cluded.They were divided into the study group(with lung infection,n=120)and the control group(without lung infection,n=230)according to the incidence of lung infection.The pathogenic bacteria characteristics of lung in-fection in patients with chronic renal failure MHD were analyzed,and the clinical data,the expression levels of TLR4 and NF-κB between the two groups were analyzed and compared.The influencing factors of lung infection in patients with chronic renal failure MHD were analyzed by multivariate logistic regression analysis.RESULTS A to-tal of 155 pathogenic bacteria were isolated from 120 patients with chronic renal failure and pulmonary infection,including 96 strains of gram-negative bacteria,accounting for 61.94％.The results of logistic regression analysis showed that the risk factors of pulmonary infection in patients with chronic renal failure undergoing MHD were in-creasing age,diabetes mellitus,high serum level of C-reactive protein(CRP),high levels of TLR-4 and NF-κB in peripheral blood monocyte(P＜0.05).Elevated serum level of hemoglobin(Hb)was a protective factor for pul-monary infection in patients with chronic renal failure undergoing MHD(P＜0.05).CONCLUSION The main pathogens of pulmonary infection in patients with chronic renal failure MHD were gram-negative bacteria.TLR4/NF-κB signaling pathway is involved in the occurrence of pulmonary infection.There are many risk factors,so in-tervention measures could be taken accordingly.
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