Pathogens and risk factor for catheter-related bloodstream infection in hemodialysis patients and diagnostic values of TGF-β1/Smads pathways
OBJECTIVE To investigate the pathogens and risk factor for catheter-related bloodstream infection(CRBSI)in hemodialysis patients and diagnostic values of transforming growth factor-β1(TGF-β1)/Smads path-ways.METHODS A total of 162 patients undergoing hemodialysis in the First Affiliated Hospital of Jinzhou Medi-cal University from Mar 2020 to Mar 2023 were selected as the study objects,and divided into the infected group(n=51)and the uninfected group(n=111)according to whether they had CRBSI.The infection status and etio-logical distribution were analyzed,and the risk factors of CRBSI in hemodialysis patients were analyzed.The pro-tein expressions of TGF-β1,Smad2 and Smad3 in serum between the two groups were compared,and the diagnos-tic value of alone and combined detection of TGF-β1,Smad2 and Smad3 in CRBSI in hemodialysis patients was an-alyzed.RESULTS The CRBSI occurred in 51 cases of 162(31.48％)hemodialysis patients.A total of 51 strains of pathogenic bacteria were cultured,and Staphylococcus aureus(27.45％),Staphylococcus hemolyticus(17.65％)and Escherichia coli(15.69％)accounted for the higher proportions.The independent risk factors for CRBSI in hemodialysis patients were diabetes mellitus,long catheter indwelling time,femoral vein placement,high puncture times and low ser-um albumin level(P＜0.05).Compared with the uninfected group,TGF-β1,Smad2 and Smad3 protein levels in serum were higher than those in the infected group(P＜0.05).The area under the diagnostic curve(AUC)value of combined detection of TGF-β1,SMad2 and SMAD3 in the diagnosis of CRBSI in hemodialysis patients was higher than that of the individual detection(P＜0.05),and the sensitivity and specificity of the combined detection was 92.16％and 80.18％,respectively.CONCLUSION S.aureus,S.hemolyticus and E.coli were the main CRBSI-related pathogens in he-modialysis patients.CRBSI can be associated with the activation of TGF-β1/Smads pathway,and the combined de-tection of TGF-β1,Smad2 and Smad3 has high diagnostic value.
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