Changes of peripheral blood TLR,25(OH)D and distribution of pathogens isolated from general anesthesia orthopedic surgery patients with postoperative pulmonary infections
10.11816/cn.ni.2025-250659
- VernacularTitle:全麻骨科术后肺部感染病原菌及其外周血TLR和25(OH)D变化
- Author:
Lijie REN
1
;
Suqing SUN
1
;
Hongli WANG
1
;
Heqiang FENG
1
;
Peng WANG
1
;
Jinxin WANG
1
;
Shimin SHAN
1
Author Information
1. 天津市第五中心医院(北京大学滨海医院)麻醉科,天津 300450
- Publication Type:Journal Article
- Keywords:
General anesthesia;
Orthopedics department;
Pulmonary infection;
Toll-like receptor 2;
Toll-like re-ceptor 4;
25 hydroxyvitamin D;
Etiology;
Drug resistance
- From:
Chinese Journal of Nosocomiology
2025;35(22):3405-3409
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To explore the changes of serum Toll-like receptor(TLR)2,TLR4 and 25 hydroxyvitamin D[25(OH)D]in the general anesthesia orthopedic surgery patients with postoperative pulmonary infections and analyze the distribution and drug resistance of pathogens.METHODS A total of 59 general anesthesia orthopedic surgery patients with postoperative pulmonary infections who were treated in Tianjin Fifth Central Hospital from Jul.2019 to Jul.2024 were chosen as the infection group,meanwhile,65 patients who underwent the same surger-y but did not have postoperative pulmonary infection or other acute and chronic infections were chosen as the non-infection group.The etiological characteristics of the postoperative pulmonary infections and the drug re-sistance rates were analyzed.The clinical data and the levels of serum TLR2,TLR4 and 25(OH)D were observed and compared between the two groups of patients.The values of the above indicators in diagnosis of the postopera-tive pulmonary infections in the general anesthesia orthopedic surgery were analyzed.RESULTS Totally 63 strains of pathogens were isolated from the 59 general anesthesia orthopedic surgery patients with postoperative pulmona-ry infections,36(57.14％)of which were gram-negative bacteria.3 of 15 Pseudomonas aeruginosa strains were resistant to meropenem;4 of 12 Klebsiella pneumoniae strians were resistant to meropenem;all of the 11 Staph-ylococcus aureus strains were methicilin-resistant S.aureus.The proportions of patients with age,hypoproteine-mia and diabetes mellitus,the serum TLR2 and TLR4 levels were higher in the infection group than in the non-infection group(P＜0.05),while the 25(OH)D level of the infection group was lower than that of the no in-fection group(P＜0.05).The area under the curves(AUCs)of serum TLR2,TLR4,25(OH)D and the joint de-tection of the above indicators were respectively 0.817,0.801,0.787 and 0.917 in diagnosis of postoperative pul-monary infections in the general anesthesia orthopedic surgery patients,and the AUC of the joint detection of the indicators was greater than that of the single detection(P＜0.05).CONCLUSIONS The general anesthesia or-thopedic surgery patients with postoperative pulmonary infections show high expressions of serum TLR2 and TLR4 and the low expression of 25(OH)D.The joint detection of the above indexes has higher diagnostic value.The gram-negative bacteria are dominant among the pathogens causing the infections.The pathogens vary in the drug resistance.
