Abstract：
Background: This study aims to elucidate the clinical characteristics of Shewanella-related surgical site infections (SSIs) and assess the risk of mortality in patients by establishing a predictive model. Patients and Methods: A retrospective analysis of medical history and laboratory data of Shewanella-related SSI patients over the past decade was conducted via the electronic medical record (EMR) system. A predictive model for mortality risk in Shewanella-related SSI patients was established using plasma interleukin-6 (IL-6) levels combined with the Howell-PIRO scoring system. Results: Over the past 10 years, 45 strains of Shewanella were isolated from specimens such as bile, drainage fluid, and whole blood in patients with digestive tract SSIs. Among them, 21 of 45 (46.67%) patients underwent malignant tumor resection of the digestive system, 14 of 45 (31.11%) underwent endoscopic retrograde cholangiopancreatography (ERCP) common bile duct exploration or the stone removal, and seven of 45 (15.56%) were trauma repair patients with fractures and abdominal injuries. Among the 45 Shewanella-related SSI patients, 10 died within 30 days of infection, six cases involved infections with more than two other types of bacteria. The combined use of IL-6 and Howell-PIRO scores for mortality risk assessment yielded an receiver operating characteristic (ROC) curve with an area under the curve (AUC) of 0.9350, a positive predictive value of 92.71%, a negative predictive value of 94.58%, a diagnostic sensitivity of 95.35%, and a diagnostic specificity of 92.14%-all higher than the model using IL-6 or Howell-PIRO scores alone. Conclusions: We found that residents in coastal areas faced an increased risk of Shewanella-related SSI. Moreover, the higher the number of concurrent microbial infections occurring alongside Shewanella-related SSI, the greater the mortality rate among patients. The combined application of plasma IL-6 levels and the Howell-PIRO scoring system is beneficial for assessing patient mortality risk and guiding timely and proactive clinical interventions.
摘要：
背景：本研究旨在阐明希瓦氏菌相关手术部位感染（SSIs）的临床特征，并通过建立预测模型来评估患者的死亡风险。患者和方法：通过电子病历（EMR）系统对过去十年中与Shewanella相关的SSI患者的病史和实验室数据进行了回顾性分析。采用血浆白细胞介素-6(IL-6)水平结合Howell-PIRO评分系统建立了希瓦氏菌相关性SSI患者死亡风险预测模型。结果：在过去的10年里，从胆汁等标本中分离出45株希瓦氏菌，引流液,消化道SSIs患者的全血。其中,45例(46.67%)患者中有21例接受了消化系统恶性肿瘤切除术,45例患者中有14例(31.11%)行内镜逆行胰胆管造影术(ERCP)胆总管探查或取石,45例患者中有7例(15.56%)为创伤修复伴骨折和腹部损伤患者。在45例与希瓦氏菌相关的SSI患者中，10人在感染后30天内死亡，六例涉及感染两种以上的其他细菌。联合使用IL-6和Howell-PIRO评分进行死亡风险评估产生了受试者工作特征（ROC）曲线，曲线下面积（AUC）为0.9350，阳性预测值为92.71％，阴性预测值为94.58%，诊断灵敏度为95.35%，诊断特异性为92.14%-均高于单独使用IL-6或Howell-PIRO评分的模型。结论：我们发现沿海地区的居民面临与Shewanella相关的SSI的风险增加。此外，与Shewanella相关的SSI同时发生的微生物感染数量越高，患者死亡率越高。血浆IL-6水平和Howell-PIRO评分系统的联合应用有利于评估患者死亡风险,指导及时积极的临床干预。
