| Background Infection is a perioperative complication of surgical patients.Bloodstream infection(BSI)is one of the main reasons for the increase of blood flow,especially the increase of hospital stay.Effective anti infective treatment can significantly reduce the incidence of postoperative complications and mortality of patients.At present,empirical antibiotic therapy is widely used in clinical practice,which lacks scientific basis,resulting in unnecessary abuse and a variety of side effects,such as adverse drug reactions,intestinal flora imbalance and induced drug-resistant bacteria,but aggravates the disease.Therefore,early and rapid diagnosis of postoperative BSI and scientific and reasonable guidance of the use of antibiotics is an urgent task.This study retrospectively analyzed the relationship between the quantitative level of serum procalcitonin(PCT)and clinical data of 133 patients with postoperative infection,and explored the value of quantitative detection of serum PCT in early diagnosis and antibacterial treatment of postoperative BSI and the application value of drug guidance.Objective To investigate the early diagnostic effect of PCT and the value of guiding the use of antibiotics on post-operative BSI.Methods Retrospective Analysis of 133 patients(72 of cases with BSI and 61 with localized infections)with post-operative infections from March 2017 to June 2020 in Zhongshan People’s Hospital.All the collected 133 blood samples were detected and analyzed the following indicators expression: PCT,IL-6,WBC,NEU,LY,NLR,etc.All statistical analysis were conducted using Graph Pad Prism 5.0 software,significant level was designated as α=0.05.Measurement data conforming to the normal distribution,such as the patient’s age,body temperature,and various test indicators,are expressed in terms of mean plus and minus standard deviation((?)±s).Differences between the two groups are compared using t-test,and non-normal distribution measurement data using median(Interquartile range)[M(P25-P75)] means that the Mann-Whitney U test is used for comparison between groups,the chi-square test is used for the comparison of count data,and the sensitivity and specificity of the test at different cut-off values are analyzed by ROC curve.Area under the curve.When checking the level of α,the difference is statistically significant with P<0.05.Results1、The expression of WBC,NEU,NLR,PCT and IL-6 in the BSI group were higher than in the localized infections group(P<0.05).2、The diagnostic efficiency of combined detection of PCT and IL-6 is optimal,which sensitivity and specificity were up to 83.64% and 68.66%,respectively.3、Moreover,significantly higher expression of PCT were found in patients with Gram negative infection when compared to Gram positive infection(P<0.05).4、 In Gram negative infection,the bacteria were mainly E.coli and Pneumococcal Creeber bacteria,which PCT were 2.64(0.81-5.91)ng/m L and 6.31(1.17-10.79)ng/m L.5、 While in Gram positive infection,the mainly bacteria were Staphylococcus aelobacter and Streptococcus pneumonia,and the corresponding PCT expression were 0.67(0.32-0.94)ng/m L and 2.18(0.9-3.05)ng/m L.Conclusion PCT could be an early predictive marker of post-operative BSI,and the expression level could help to speculate the possible type of pathogen,which help to provide the basis of early diagnosis of postoperative BSI as well as the accurate usage of antibiotics. |
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