Changes and significance of autophagy in peripheral blood lymphocytes of patients with carbapenem-resistant Enterobacteriaceae-bloodstream infection

doi:10.3969/j.issn.1673-8640.2024.08.007

Abstract

Abstract:

Objective To analyze the characteristics and clinical significance of autophagy in peripheral blood lymphocytes of patients with carbapenem-resistant Enterobacteriaceae（CRE）-bloodstream infection（BSI）. Methods Totally，125 patients with CRE-BSI（drug-resistant group） and 130 patients with carbapenem-sensitive bacterium-BSI（drug-sensitive group） were enrolled from the Second People's Hospital of Nantong from June 2019 to June 2022，and 105 healthy subjects were enrolled as control group. The mRNA expression levels of autophagy marker genes（Beclin-1，LC3 and Atg5a） in peripheral blood lymphocytes were determined，and the differences were compared. The clinical data of drug-resistant group were collected. The differences of clinical characteristic and Beclin-1，Atg5a，LC3 mRNA levels between death and survival patients were compared. Logistic regression analysis was used to evaluate the prognostic factors in drug-resistant group. Results The Beclin-1，LC3 and Atg5a mRNA levels of peripheral blood lymphocytes in drug-resistant group were lower than those in drug-sensitive group and control group（P<0.05）. Beclin-1，LC3 and Atg5a mRNA levels in peripheral blood lymphocytes in drug-resistant group were negatively correlated with acute physiological and chronic health evaluation Ⅱ（APACHE Ⅱ） score，white blood cell（WBC） count，high-sensitivity C-reactive protein（hs-CRP） and procalcitonin（PCT） levels（P<0.05）. There was statistical significance in Beclin-1，LC3 and Atg5a mRNA levels and age，respiratory tract infection，septic shock，hs-CRP，PCT and APACHE Ⅱ scores between death and survival patients in drug-resistant group（P<0.05）. Beclin-1 and LC3 mRNA levels in peripheral blood lymphocytes，respiratory tract infection，septic shock and APACHE Ⅱ score were the influential factors for death in drug-resistant group（P<0.05）. Conclusions The weakened autophagy of peripheral blood lymphocytes in CRE-BSI patients is related to disease aggravation and poor prognosis.

Key words: Carbapenem-resistant Enterobacteriaceae, Bloodstream infection, Lymphocyte, Autophagy, Prognosis

CLC Number:

R378.99

HUANG Linling, XU Meirong, SHEN Xiaowen, GU LingLi, SHEN Hongmei. Changes and significance of autophagy in peripheral blood lymphocytes of patients with carbapenem-resistant Enterobacteriaceae-bloodstream infection[J]. Laboratory Medicine, 2024, 39(8): 759-763.

Figures/Tables 5

References 19

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组别	例数	Beclin-1 mRNA	LC3 mRNA	Atg5a mRNA
耐药组	125	0.58±0.07^*#	0.51±0.05^*#	0.71±0.09^*#
敏感组	130	0.74±0.10^*	0.81±0.11^*	0.83±0.12^*
对照组	105	1.00±0.15	1.00±0.19	1.00±0.18
F值		34.835	57.115	45.345
P值		<0.001	<0.001	<0.001

组别	例数	Beclin-1 mRNA	LC3 mRNA	Atg5a mRNA
耐药组	125	0.58±0.07^*#	0.51±0.05^*#	0.71±0.09^*#
敏感组	130	0.74±0.10^*	0.81±0.11^*	0.83±0.12^*
对照组	105	1.00±0.15	1.00±0.19	1.00±0.18
F值		34.835	57.115	45.345
P值		<0.001	<0.001	<0.001

指标	Beclin-1 mRNA		LC3 mRNA		Atg5a mRNA
指标	r值	P值	r值	P值	r值	P值
APACHE Ⅱ评分	-0.341	0.018	-0.401	<0.05	-0.355	0.015
WBC	-0.362	0.015	-0.357	<0.05	-0.421	0.005
hs-CRP	-0.294	0.025	-0.324	<0.05	-0.392	0.009
PCT	-0.344	0.018	-0.409	<0.05	-0.385	0.009

指标	Beclin-1 mRNA		LC3 mRNA		Atg5a mRNA
指标	r值	P值	r值	P值	r值	P值
APACHE Ⅱ评分	-0.341	0.018	-0.401	<0.05	-0.355	0.015
WBC	-0.362	0.015	-0.357	<0.05	-0.421	0.005
hs-CRP	-0.294	0.025	-0.324	<0.05	-0.392	0.009
PCT	-0.344	0.018	-0.409	<0.05	-0.385	0.009

项目	例数	Beclin-1 mRNA	LC3 mRNA	Atg5a mRNA
死亡患者	93	0.40±0.07	0.38±0.05	0.60±0.08
存活患者	32	0.64±0.08	0.55±0.06	0.75±0.11
t值		15.091	14.390	7.088
P值		<0.001	<0.001	<0.001