Characteristics of pathogenic bacteria in patients with acute stroke complicated with bacterial pneumonia and the evaluation value of sTREM-1 and CRP/ALB

Zhang Zhen; Hou Dengfeng; Shen Dapeng

doi:10.3969/j.issn.1672-8521.2025.03.006

Abstract：Objective:To analyze the characteristics of pathogenic bacteria in acute stroke patients with bacterial pneumonia and the value of soluble triggering receptor expressed on myeloid cells-1(sTREM-1)and C-reactive protein/albumin ratio(CRP/ALB)and the evaluation of bacterial pneumonia.Methods:A total of 107 patients with acute stroke admitted to Zhengzhou Renji Hospital from October 2021 to October 2023 were selected as the study objects.According to their pulmonary infection status,they were divided into infection group(patients with acute stroke complicated with bacterial pneumonia,n=42)and non-infection group(patients with acute stroke without bacterial pneumonia,n=65).The characteristics of pathogenic bacteria and drug resistance in sputum culture of patients in the infected group were analyzed,and the levels of sTREM-1 and CRP/ALB were compared between the two groups.The value of sTREM-1 and CRP/ALB in diagnosing the occurrence of bacterial pneumonia in patients with acute stroke was analyzed by receiver operating characteristics(ROC)curve.Results:Among the 42 patients with acute stroke complicated with bacterial pneumonia,4 cases(9.52%)were infected with Gram-positive bacteria,of which Staphylococcus aureus was the most common;and 38 cases(90.48%)were infected with Gram-negative bacteria,of which Klebsiella pneumoniae and Escherichia coli were the most common.Staphylococcus aureus had lower drug resistance to cefixime,cefmetazole and vancomycin.Klebsiella pneumoniae,Escherichia coli and Pseudomonas aeruginosa had lower drug resistance to ciprofloxacin and amikacin(33.33%,33.33%,0 respectively).The levels of serum sTREM-1 and CRP/ALB in the infection group[(2.15±0.87)ng/L and 4.26±1.15,respectively]were higher than those in the non-infection group[(1.54±0.47)ng/L and 2.53±0.76;t=4.697,9.376,P＜0.001].The area under the curve(AUC)of serum sTREM-1 and CRP/ALB was significantly higher than the reference line(AUC were 0.756 and 0.956),and the cut-off values were 2.04 ng/L and 3.60,respectively.Conclusions:Bacterial pneumonia in patients with acute stroke is mostly Gram-negative bacterial infection.Ciprofloxacin and amikacin can be selected as conventional anti-Gram-negative bacterial infection drugs.Clinical detection of serum sTREM-1 and CRP/ALB levels can also be used to determine whether the patient is complicated with bacterial pneumonia at an early stage.