OBJECTIVE To observe the expressions of microribonucleic acid (miR)-155, miR-141, interleukin (IL)-22 and IL-17 in peripheral blood of the chronic renal failure (CRF) and hemodialysis (HD) patients complicated with hospital-associated infections and analyze the clinical treatment outcomes.

METHODS A total of 561 CRF patients who underwent HD in Wuhan First Hospital from Jun. 2022 to Jun. 2023 were enrolled in the study and were divided into the infection group with 182 cases and the non-infection group with 379 cases according to the status of hospital-associated infections. The patients of the infection group were divided into the survival group with 138 cases and the death group with 44 cases according to the clinical therapeutic outcomes of a 6-month follow-up. The distribution of pathogens isolated from the CRF HD patients with hospital-associated infections was analyzed, the clinical data were compared between the infection group and the non-infection group; the levels of serum miR-155, miR-141, IL-22 and IL-17 were observed and compared among the groups. The values of the serologic markers in prediction of the clinical therapeutic outcomes of the CRF HD patients with hospital-associated infections were analyzed by receiver operating characteristic (ROC) curves.

RESULTS The proportions of patients with no less than 1 year of hemodialysis, femoral venous catheter indwelling and long-term catheter indwelling were higher in the infection group than those in the non-infection group (P < 0.05). Totally 202 strains of pathogens were isolated from the infection group, 125 (61.88%) of which were gram-negative bacteria. There were significant differences in the levels of serum miR-155, miR-141, IL-22 and IL-17 between the infection group and the no infection group (P < 0.05), the biomarker with the greatest difference value was miR-141 (t=37.145, P < 0.001). As compared with the patients with different therapeutic outcomes in the infection group, there were significant differences in the levels of serum miR-155, miR-141, IL-22 and IL-17 between the survival group and the death group(P < 0.05), and the index with the greatest difference value was IL-17 (t=35.848, P < 0.001). The values of the four markers in prediction of the therapeutic outcomes of the CRF HD patients complicated with hospital-associated infections were analyzed by ROC curves, and the area under the curve (AUC) of the joint detection 0.922 was the highest (P < 0.05).

CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the CRF HD patients complicated with hospital-associated infections. The levels of serum miR-155, miR-141, IL-22 and IL-17 are elevated with the incidence of infections and deterioration of prognosis. The joint detection of the markers has high predictive value.