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识别老年患者菌血症的关键血液标志物:对细菌病原体的见解

Identifying key blood markers for bacteremia in elderly patients: insights into bacterial pathogens.

作者信息

Zhang Shi-Yan, Zhuo Ying, Li Bu-Ren, Jiang Ying-Ying, Zhang Jie, Cai Na, Yang Lin

机构信息

Department of Clinical Laboratory, Fuding Hospital, Fujian University of Traditional Chinese Medicine, Fuding, Fujian, China.

出版信息

Front Cell Infect Microbiol. 2025 Jan 16;14:1472765. doi: 10.3389/fcimb.2024.1472765. eCollection 2024.

Abstract

BACKGROUND

This study aimed to assess the distribution of bacteremia pathogens in elderly patients, examine the impact of gender on pathogen distribution, and evaluate the predictive value of routine blood parameters for diagnosing bacteremia.

METHODS

A retrospective analysis was conducted on 151 elderly patients (≥60 years old) admitted to Fuding Hospital, Fujian University of Traditional Chinese Medicine between October 2022 and June 2023. Comprehensive routine blood tests and blood cultures were performed. The diagnostic efficacy of routine blood parameters, including white blood cell (WBC), neutrophil-to-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and red blood cell distribution width (RDW), was evaluated using receive operating characteristic (ROC) curve analysis. Patients were categorized into either the culture-positive group (82 cases) or the culture-negative group (69 cases) according to blood culture results.

RESULTS

No significant differences in age and gender were found between the culture-positive and culture-negative groups. The primary bacterial pathogens of bacteremia in the elderly were , and . Elderly female patients demonstrated a significantly higher culture positivity rate for compared to their male counterparts ( = 0.021). The areas under the ROC curve (AUC) for the four parameters were as follows: WBC, 0.851 (95% confidence interval (CI) 0.790 - 0.912); NLR, 0.919 (95% CI 0.875 - 0.963); PLR, 0.609 (95% CI 0.518 - 0.700); and RDW was 0.626 (95% CI 0.563 - 0.717).

CONCLUSIONS

was identified as the predominant pathogenic microorganism causing bacteremia in the elderly, with a significantly higher culture positivity rate among female patients. Routine blood parameters (WBC, NLR, PLR, and RDW) demonstrated a predictive potential for diagnosing bacteremia in elderly patients.

摘要

背景

本研究旨在评估老年患者菌血症病原体的分布情况,探讨性别对病原体分布的影响,并评估常规血液参数对菌血症诊断的预测价值。

方法

对2022年10月至2023年6月期间福建中医药大学附属福鼎医院收治的151例老年患者(≥60岁)进行回顾性分析。进行了血常规和血培养检查。采用受试者工作特征(ROC)曲线分析评估包括白细胞(WBC)、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)及红细胞分布宽度(RDW)在内的常规血液参数的诊断效能。根据血培养结果将患者分为培养阳性组(82例)和培养阴性组(69例)。

结果

培养阳性组和培养阴性组在年龄和性别方面无显著差异。老年菌血症的主要病原菌为 、 和 。老年女性患者 的培养阳性率显著高于男性患者( = 0.021)。四个参数的ROC曲线下面积(AUC)如下:WBC为0.851(95%置信区间(CI)0.790 - 0.912);NLR为0.919(95%CI 0.875 - 0.963);PLR为0.609(95%CI 0.518 - 0.700);RDW为0.626(95%CI 0.563 - 0.717)。

结论

被确定为导致老年人菌血症的主要致病微生物,女性患者的培养阳性率显著更高。常规血液参数(WBC、NLR、PLR和RDW)对老年患者菌血症的诊断具有预测潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff6d/11779733/ad6b2f7895b6/fcimb-14-1472765-g001.jpg

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