Early warning factors of fungal bloodstream infection in severely burned patients and the expression of TRF1 mRNA,TRF2 mRNA,TREM1 and sCD163
CHEN Nanxiong
HU Xiaorui
MA Rui
MIAN Ruiqing
Abstract：Objective To analyze the early warning factors of fungal bloodstream infection in severely burned patients and the significance of the expression of human telomere repeat binding factor 1(TRF1)mRNA,human telomere repeat binding factor 2(TRF2)mRNA,myeloid cell trigger receptor 1(TREM1)and soluble hemoglobin scavenger receptor(sCD163).Methods A total of 534 patients with severe burns admitted to the General Hospital of Ningxia Medical University from January 2020 to January 2025 were selected as the research objects.According to the occurrence of fungal bloodstream infection,the patients were divided into the infection group(52 cases)and the non-infection group(482 cases).The etiological characteristics and single factors of fungal bloodstream infection in patients with severe burns were statistically analyzed,and the early warning factors of fungal bloodstream infection in patients with severe burns were analyzed.The diagnostic value of TRF1 mRNA,TRF2 mRNA,TREM1 and sCD163 expression for fungal bloodstream infection in patients with severe burns was analyzed.Results A total of 55 strains of pathogenic fungi were isolated from 52 patients with fungal bloodstream infection.The main pathogenic fungi were Candida albicans and C.parapsilosis,accounting for 30.91%and 20.00%,respectively.The burn area,number of operations before infection,acute physiology and chronic health evaluation(APACHE II)score,sequential organ failure score,proportion of patients with broad-spectrum antibiotic use time≥7 d,proportion of patients with broad-spectrum antibiotic types≥3,TRF1 mRNA,TRF2 mRNA,TREM1 and sCD163 expression levels in the infected group were higher than those in the non-infected group(P＜0.05).Larger burn area,broad-spectrum antibiotic use time≥7 d,broad-spectrum antibiotic types≥3,and higher expression levels of TRF1 mRNA,TRF2 mRNA,TREM1,and sCD163 were all early warning factors for fungal bloodstream infection in patients with severe burns(OR=1.454,1.655,1.534,1.621,1.820,1.853,1.662,P＜0.05).The area under the curve of the combined detection of TRF1 mRNA,TRF2 mRNA,TREM1 and sCD163 expression in the diagnosis of fungal bloodstream infection in patients with severe burns was higher than that of the four alone(P＜0.05),and the sensitivity and improvement were 78.85%and 85.89%,respectively.Conclusion The main pathogenic fungi of severe burn patients with fungal bloodstream infection were C.albicans and C.parapsilosis.The occurrence of fungal bloodstream infection could increase the expression levels of TRF1 mRNA,TRF2 mRNA,TREM1 and sCD163.The early warning factors included large burn area,broad-spectrum antibiotic use time≥7 d,broad-spectrum antibiotic types≥3,and higher expression levels of TRF1 mRNA,TRF2 mRNA,TREM1 and sCD163.Further analysis of the combined expression of TRF1 mRNA,TRF2 mRNA,TREM1 and sCD163 could improve the diagnostic value of fungal bloodstream infection in patients with severe burns.
Keywords：burnseverefungibloodstream infectionearly warning factors
Publication Date：2025-12-28
Online Publishing Date：2026-01-06(First online date of this platform, not the publication date of the document)
Pages：7( 624-630 )