| Objective1To understand bloodstream infections bacteria composition, department distribution,age distribution and related situation, and provide the basis for clinical diagnosis andtreatment.2To evaluate the value of Interleukin-1(IL-1beta), Interleukin-6(IL-6), Interleukin-8(IL-8), Tumor necrosis factor alpha (TNF alpha), and united detection in diagnosisof bacterial bloodstream infections.MethodsBlood specimens of patients were collected from clinical departments in the FirstAffiliated Hospital of Anhui Medical University in2011，WHONET5.4was applied foranalyzing the composition, distribution of blood culture strain and related situation. Theserum of144cases of bacterial bloodstream infections(68cases of Gram-negativebacteria and76cases of Gram-positive bacteria) and32cases of healthy controls, werecollected. Using the SYSMEX XE-2100(F5192) blood routine analyzer to detect WBClevel, Using the Hitachi7600automatic biochemical analyzer to detect hs-CRP level,Adopting SIMENS Immulite1000chemiluminescence analyzer to detect serumIL-1β,IL-6,IL-8,TNF-α level. ResultsIn2011, a total of527strains were isolated, including299Gram-negative bacteriastrains (56.7﹪) and228Gram-positive bacteria strains (43.3﹪). In the Gram-positivebacteria,185Coagulase negative staphylococcus strains (36.2%) in the first place, wereisolated; The second is48Enterococcus strains (9.1%),35Staphylococcus aureus strains(6.6%). In the Gram-negative bacteria, Escherichia coli is the most, a total of125strains(23.7%), followed by41Klebsiella pneumoniae strains (7.7﹪),14Acinetobacterbaumannii strains (2.7%). Escherichia coli bloodstream infections mainly occur in theHematology department and infectious disease department, patients over age40are inthe majority. Staphylococcus aureus bloodstream infections mostly occur in theDermatology Department, patients over age60are in the majority. Coagulase negativestaphylococcus bloodstream infections mainly occur in pediatric department.Gram-negative bacteria and Gram-positive bacteria infection group of IL-1β,IL-6, IL-8,TNF-α,hs-CRP,WBC were significantly higher than that of normal controlgroup(P<0.05). Between Gram-negative bacteria and Gram-positive bacteria infectiongroup, there was not statistically significant. Analyse the positive rate of cytokinesindex, L-1β,IL-6, IL-8, TNF-α between infection group and normal control group weresignificant differences(P<0.01), χ2value were21.84,111.51,16.37,64.01respectively.Between infection groups, there was not statistically significant. The positive rate ofIL-6, TNF-α in infection group is higher than IL-1β, IL-8. The positive rate of IL-6inGram-positive bacteria infection group, Gram-negative bacteria infection group andnormal group were86.8%,94.1%,0%respectively; The positive rate of TNF-α inGram-positive bacteria infection group, Gram-negative bacteria infection group andnormal group were86.8%,92.6%,25%respectively; The positive rate of uniteddetection of IL-6,TNF-α in the three groups, were96.1%,95.6%,25%respectively. Compare the positive rate of four cytokines indexs according to the ROC curve todetermine reference range, it is found that reference range of IL-1β,IL-6,IL-8is inaccordance with that of the specification provided, but reference range of TNF-α(0~13.35ng/L）and reference range of the specification provided（TNF-α：0~5.9ng/L）is rather different, the positive rate of that in Gram-positive bacteria infection group,Gram-negative bacteria infection group and normal group were68.4%,55.9%,9.4%respectively. The positive rate of united detection of IL-6,TNF-α in the three groups,were92.1%,95.6%,9.4%respectively.Conclusion1Bacterial bloodstream infection is main Gram-positive bacteria, Coagulase negativestaphylococcus strains are the most.2Bacterial bloodstream infections mainly occur in the hematology department,infectious disease department and pediatric department.3The diagnostic value of IL-6is the highest than L-1β,IL-8, TNF-α.4The united detection of IL-6,TNF-α is useful in the diagnosis of bacterialbloodstream infections. |
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