Correlation between procalcitonin and bacterial community characteristics and prognosis of patients with bacteremia after bone marrow transplantation

doi:10.3969/j.issn.1006-7795.2021.05.006

Abstract

Abstract: Objective To investigate the correlation between procalcitonin (PCT) and bacterial bloodstream infection in the prediction of systemic bacterial infection and prognosis for the patients after bone marrow transplantation. Methods A total of 197 patients with bacterial bloodstream infection after bone marrow transplantation were enrolled and divided into groups according to whether they had agranulocytosis, type of infected bacteria, site of infection, and prognosis of infection. The clinical data were collected, and the blood culture, inflammation and biochemical indexes were detected. The difference of each index between the groups was compared to analyze its clinical significance. Results The PCT in the patients with granulocytopenia was significantly higher than that without granulocytopenia [PCT:1.64(0.25, 10.12) ng/ mL vs 0.76(0.28, 2.72) ng/ mL, P<0.05]. The infection sites of the patients showed the characteristics of patients with immunocompromised blood diseases. The most common infection sites were lung, perianal and digestive system, with no significant difference in PCT between the different infection sites. K-M survival curve analysis showed that the survival rate of the patients with bacteremia after bone marrow transplantation decreased with the increased of PCT. COX analysis showed that PCT, creatinine (CRE), and infection with gram-negative bacteria were the risk factors for infection and death, while albumin (ALB) was the protective factor (all of which were statistically significant). In particular, the gram-negative bacteria infection was a major risk factor for death (HR:3.729,95%CI:1.001-13.888, P=0.05), regardless of grain deficiency and infection site. Conclusion In patients with bacterial bloodstream infection after bone marrow transplantation, the PCT was significantly increased in patients with granulopathy. With the increase of PCT value and gram-negative bacteria infection, the survival rate of bacteremia patients after bone marrow transplantation decreased. The gram-negative bacteria infection was the main risk factor for death.

Key words: procalcitonin, marrow transplantation, bacteremia

CLC Number:

R446

Li Shanshan, Bao Huizhang, Sun Yi,Wang Chunyan, Jia Mei. Correlation between procalcitonin and bacterial community characteristics and prognosis of patients with bacteremia after bone marrow transplantation[J]. Journal of Capital Medical University, 2021, 42(5): 726-732.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2021.05.006

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2021/V42/I5/726

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