OBJECTIVE To investigate the resistance of pathogenic bacteria in patients with traumatic brain injury combined with pulmonary infection and serum soluble myeloid triggering receptor-1 (sTREM-1), C-reactive protein to albumin ratio (CRP/ALB), tissue factor pathway inhibitor-1 (TFPI-1), peripheral blood prealbumin (PA), and D-dimer (D-D) levels and their predictive values.
METHODS One hundred and one patients with traumatic brain injury combined with pulmonary infection admitted to Taiyuan Iron and Steel (Group) Co. general hospital from Jan. 2022 to Oct. 2023 were selected as the infected group, and 115 patients with traumatic brain injury without pulmonary infection admitted to the hospital during the same period were selected as the uninfected group. Pathogenic bacteria resistance was analyzed, and sTREM-1, CRP/ALB, TFPI-1, PA, and D-D levels were compared between the two groups. The predictive values of serum sTREM-1, CRP/ALB, TFPI-1, peripheral blood PA, and D-D for pulmonary infections in patients with traumatic brain injury was analyzed by the receiver operating characteristics (ROC) curve.
RESULTS A total of 112 strains of pathogenic bacteria were detected in 101 patients with traumatic brain injury combined with lung infections, including 67 strains of gram-negative (59.82%), 36 strains of gram-positive (32.14%), and 9 strains of fungal strains (8.04%), with Pseudomonas aeruginosa, Klebsiella pneumoniae, and Staphylococcus aureus predominantly. The levels of sTREM-1, CRP/ALB, TFPI-1, and D-D in the infected group were (36.73±9.85) pg/ml, (4.02±1.25), (42.31±9.75) μg/L, and (9.72±3.14) mg/L, respectively, higher than those in the uninfected group (P < 0.05). Tracheotomy time was (19.34±2.24) d, longer than that of the uninfected group (P < 0.05), and peripheral blood PA was (162.76±38.32) mg/L, lower than that of the uninfected group (P < 0.05). The area under the curve (AUC) value of the combined detection of sTREM-1, CRP/ALB, TFPI-1, PA, and D-D for the prediction of pulmonary infections in traumatic brain injury patients was 0.943, higher than that of single detection.
CONCLUSIONS Gram-negative bacteria are the main causative organisms in patients with traumatic brain injury combined with pulmonary infections, and the resistance characteristics of different causative organisms varied. serum sTREM-1, CRP/ALB, TFPI-1, and peripheral blood D-D are highly expressed in patients with traumatic brain injury combined with pulmonary infections, whereas PA is lowly expressed, and the combination of the five indexes are of higher value in predicting the occurrence of pulmonary infections in patients with traumatic brain injury.
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