Pathogens and expressions of serum H-FABP, sTREM-1, TLR4 and HMGB1 for ureteral calculi patients with postoperative urinary sepsis

OBJECTIVE To investigate the distribution and drug resistance of pathogens isolated from the ureteral calculi patients with postoperative urinary sepsis (US) and analyze the values of serum human heart-type fatty acid binding protein (H-FABP), soluble triggering receptor expressed on myeloid cells (sTREM-1), Toll-like receptor 4(TLR4) and high mobility group protein B1(HMGB1) in diagnosis of US.

METHODS Totally 230 ureteral calculi patients with postoperative US and 237 ureteral calculi patients without postoperative US who were treated in Kunshan Hospital of Integrated Traditional Chinese and Western Medicine from Jun. 2021 to Dec. 2023 were enrolled in the study and were assigned as the US group and the non-US group, respectively. The distribution of pathogens isolated from the ureteral calculi patients with postoperative US and the drug resistance rates of the major species of pathogens were statistically analyzed. The levels of serum H-FABP, sTREM-1, TLR4 and HMGB1 were compared between the US group and the non-US group. The values of the four indexes in diagnosis of postoperative US in the ureteral calculi patients were analyzed.

RESULTS Among the pathogens isolated from the ureteral calculi patients with postoperative US, gram-negative bacteria accounted for 70.16%, and gram-positive bacteria accounted for 27.35%. Escherichia coli, Serratia marcescens, Enterococcus faecium and Enterococcus faecalis were the major species of pathogens and were resistant to most of the antibiotics. There were significant difference in the levels of serum H-FABP, sTREM-1, TLR4 and HMGB1 between the US group and the non-US group (P < 0.05), and the index with the greatest difference was H-FABP (29.83±4.97)ng/ml vs.(23.76±4.62)ng/ml. The area under the curve (AUC) of the joint detection of the four indexes was higher than that of the single detection in diagnosis of postoperative US in the ureteral calculi patients (P < 0.05).

CONCLUSIONS There are differences in the drug resistance rates among the major species of pathogens isolated from the ureteral calculi patients with postoperative US. The US may lead to the rise of the levels of serum H-FABP, sTREM-1, TLR4 and HMGB1 of the patients with ureteral calculi. The joint detection of the four indexes can effectively improve the diagnosis of postoperative US in the ureteral calculi patients.