尿毒症维持性血液透析患者CRI病原菌分布特征及CRI与血清MCP-1、G-CSF、HBD-3的关系OA

Objective To investigate the distribution characteristics of catheter-related infection(CRI)pathogens and their relationship with serum monocyte chemoattractant protein-1(MCP-1),granulocyte colo-ny-stimulating factor(G-CSF),human β-defensin-3(HBD-3)and CRI in uremic patients undergoing mainte-nance hemodialysis(MHD).Methods A total of 168 uremic MHD patients admitted to Union Jiangbei Hos-pital,Huazhong University of Science and Technology from April 2023 to April 2025 were selected as the study subjects.The patients were divided into a CRI group and a non-CRI group according to whether CRI oc-curred during catheter indwelling or within 48 h after catheter removal.The distribution of pathogens in ure-mic MHD patients with CRI was analyzed.Serum levels of MCP-1,G-CSF and HBD-3 were measured in all patients by enzyme-linked immunosorbent assay.Multivariate Logistic regression analysis was performed to i-dentify the factors influencing the occurrence of CRI in uremic MHD patients.Receiver operating characteris-tic(ROC)curve was plotted to evaluate the predictive efficacy of serum MCP-1,G-CSF,HBD-3 and their combination for CRI occurrence in uremic MHD patients.Results A total of 86 pathogenic strains were isola-ted from 82 uremic MHD patients with CRI,including 54 strains of Gram-negative bacteria(62.79%),27 strains of Gram-positive bacteria(31.40%),and 5 strains of fungi(5.81%).Serum levels of MCP-1 and G-CSF in the CRI group were significantly higher than those in the non-CRI group(P<0.05),whereas the ser-um HBD-3 level in the CRI group was significantly lower than that in the non-CRI group(P<0.05).Elevated serum MCP-1 and G-CSF levels were identified as risk factors for CRI in uremic MHD patients(P<0.05),whereas elevated serum HBD-3 level was identified as a protective factor against CRI in uremic MHD patients(P<0.05).The areas under the curves(AUCs)of serum MCP-1,G-CSF and HBD-3 for predicting CRI in uremic MHD patients were 0.862,0.848 and 0.800 respectively,with sensitivities of 89.02%,87.80%and 65.85%,and specificities of 66.28%,63.95%and 77.91%respectively.The AUC of the combination of MCP-1,G-CSF and HBD-3 for predicting CRI in uremic MHD patients was 0.943,which was significantly greater than the AUC of any single index(Zcombination vs.MCP-1=2.621,Pcombination vs.MCP-1=0.009;Zcombination vs.G-CSF=2.865,Pcombination vs.G-CSF=0.004;Zcombination vs.HBD-3=4.172,Pcombination vs.HBD-3<0.001).Conclusion Serum MCP-1,G-CSF and HBD-3 are closely associated with the occurrence of CRI in uremic MHD patients.Combined detection of these three indicators may facilitate clinical prediction of CRI in uremic MHD patients.