Etiological characteristics of postoperative nosocomial infection and expression of inflammatory factors of HMGB1/TLR4 signaling pathway in elderly patients with colorectal cancer
OBJECTIVE To analyze the distribution of pathogens causing of postoperative nosocomial infection and the expression of serum inflammatory factors and high-mobility group protein B1(HMGB1)/Toll-like receptor 4(TLR4)signaling pathway in elderly patients with colorectal cancer.METHODS A total of 356 elderly patients who received postoperative infection after laparoscopic radical resection of colorectal cancer in Shengjing Hospital affiliated to China Medical University from Mar 2019 to Mar 2021 were recruited in the study.They were divided into the infected group(80 cases)and the non-infected group(276 cases)according to whether the infection oc-curred after surgery.The pathogen distribution and etiological characteristics of postoperative nosocomial infection in patients were analyzed.The expression changes of inflammatory factors in HMGB1/TLR4 signaling pathway between the two groups were analyzed.And the relationship between the expression level of serum inflammatory factors and prognosis was analyzed.RESULTS The constituent ratio of 80 patients with infection was mainly inci-sional infection(45.00％).A total of 85 strains of pathogenic bacteria were isolated from 80 patients,of which 56 strains were gram-negative,accounting for 65.88％,mainly Escherichia coli,which was highly drug-sensitive to meropenem and levofloxacin,and highly drug-resistant to ceftriaxone,amoxicillin and cefazolin.Twenty-six strains were gram-negative strains,accounted for 30.59％,mainly Staphylococcus aureus,which had high drug resistance to penicillin,levofloxacin and clindamycin,and high drug sensitivity to vancomycin.Fungi accounted for 3.53％.Compared with the non-infected group,mRNA relative expression levels and protein expression levels of PCT,TNF-α,IL-1β,IL-6,IL-8,IL-10,HMGB1 and TLR4 in the infected group were increased(P＜0.05).Of the 356 elderly patients,12 died after operation,with a fatality rate of 3.37％.Compared with the survival group,the mRNA relative expression levels and protein expression levels of PCT,TNF-α,IL-1β,IL-6,IL-8,IL-10,HMGB1 and TLR4 in the death group were increased(P＜0.05).CONCLUSION The main pathogens of infection after laparoscopic radical resection of elderly colorectal cancer are Gram-negative bacteria,which are closely related to the prognosis of patients with changes in serum HMGB1,TLR4 and inflammatory factors.
Senile colorectal cancerPostoperative infectionPathogenInflammatory factorPrognosisHigh-mobility group protein B1Toll-like receptor 4
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