OBJECTIVE To explore the pathogens and risk factors for nosocomial infections in the perioperative blood transfusion patients and analyze the predictive values of peripheral blood natural killer (NK) cell, soluble intercellular cell adhesion molecule-1 (sICAM-1) and absolute neutrophil count (ANC).

METHODS A total of 185 patients who underwent blood transfusion during perioperative period in Inner Mongolia Medical University Affiliated Hospital from Feb. 2021 to Feb.2023 were recruited as the research subjects. The incidence of nosocomial infection, constituent ratios of pathogens, peripheral blood NK cells, sICAM-1 and ANC were observed after the surgery for 30 days.

RESULTS The incidence of nosocomial infection was 11.35%(21/185). Among the patients with nosocomial infection, the patients who had surgical incision infection accounted for 47.62%, and the patients who had deep abdominal pelvic cavity infection accounted for 23.81%. There were 13 (37.14%) strains of gram-positive bacteria, 15 (42.86%) strains of gram-negative bacteria and 7 (20.00%) strains of fungi. The logistic regression analysis showed that complication with diabetes mellitus and invasive procedures were the risk factors for the nosocomial infection in the perioperative blood transfusion patients(P < 0.05). There were significant differences in the levels of peripheral blood NK cells, sICAM-1 and ANC at different time points between the two groups(P < 0.05). Ther were no significant differences in the levels of peripheral blood NK cells, sICAM-1 and ANC between before the surgery and after the surgery for 30 days as well as among the patients without infection; the level of peripheral blood NK cells of the patients with infection was lower than that of the patients without infection after the surgery for 3 and 7 days(P < 0.05); the levels of sICAM-1 and ANC of the patients with infection were higher than those of the patients without infection(P < 0.05). The area under curve (AUC) of the joint detection of NK cells, sICAM-1 and ANC after the surgery for 3 days was the highest (P < 0.05).

CONCLUSIONS The incidence rates of surgical incision infection and deep abdominal pelvic cavity infection are relatively high among the peripheral blood transfusion patients. The patients with gram-negative bacteria infection are dominant. The infection is associated with a variety of factors. The patients with infection show abnormal levels of peripheral blood NK cells, sICAM-1 and ANC. The joint detection of the above indexes may facilitate the clinical prediction of risk of infection.