دراسة تأثير الالتهابات البكتيرية على بعض العوامل الفسيولوجية والكيموحيويه لمرضى الفشل القلبي في محافظة كربلاء

Study Effect of Bacterial Infections on Some Physiological and Biochemical Parameters in Heart Failure Patients, in Karbala

Summary
The aim of the study is to identify the most common bacterial species that are responsible for sepsis in heart failure patients, study their relationship with risk factors for heart failure and determine their antibiotic susceptibility pattern.
The study was done from October-2020 to May-2021 in the Heart Center in Hospital of Imam Hussain Medical City in Karbala. Ten ml of venous blood sample where taken from 71 heart failure patients after admission to the CCU and the same number for control. There are important procedure of blood culturing we have to fallow it, after that many analyses had been conducted such as CRP, BNP, Troponin, Lipid profile (TC, HDL, LDL and TG), Renal function tests (Urea Creatinine), General parameters (Age, Weight, Gender), Physiological Parameters (ABO, CBC, Systolic Blood Pressure, Diastolic Blood Pressure and Glucose), Microbiological tests (Bacterial Identification and Antibiotics Susceptibility Tests) and Nanotechnology study (XRD, FTIR, AFM, SEM and the inhibitory efficacy of Free-Meropenem and Nano-Meropenem.
The results were CRP (46.013) mg/l, BNP(218.84) ng/dl, Troponin (Heart Failure Without Bacterial Infection (924.526) ng/ml and Heart Failure With Bacterial Infection (383.97) ng/ml, TG (138.61) mg/dl, HDL (44.323) mg/dl , LDL (113.249) mg/dl, TC (160.423) mg/dl, Creatinine (1.343) mg/dl, Urea (62.658) mg/dl, RDW SD (49.253) fl, RDW CV (49.253) %, NEUT (70.129) %, LYM (20.329) %, MCHC in patient of heart failure with bacterial infection (31.393) g/dl, HgB (12.804) g/dl, WBC (12.670) 103/ µl, Glucose (202.336) mg/dl. And the common blood group in heart failure with bacterial infection was O. The most common bacterial causes infection for heart failure patients was Staphylococcus hominis ssp hominis and the common antibiotic resistance to the most it was meropenem. In heart failure there were some correlation between some parameters like RBC with both HGB and HCT, as it was positive correlation (0.728 and 0.792), respectively. Also there were correlation in HGB with HCT and between MCV with MCH as it was positive correlation too (0.893 and 0.890), respectively. Significances correlation at (0.01) can also be seen between PDW and both MPV and P-LCR as it was positive correlation (0.733 and 0.737), respectively too. In the same time there was Significances correlation at (0.05) between MPV and P-LCR, as it was positively (0.503). Correlation also seen between TC and both HDL and LDL, as it was positive correlation (0.661 and 0.937), respectively. And between LDL and HDL, as it was positive correlation (0.534). There was correlation between Urea and Creatinine, as it was positive correlation (0.548). Lastly there was correlation between DBP and SBP, as it was positive correlation (0.709). In heart failure with bacterial infection there were some difference correlation parameters like in MCHC with MCH, as it was positive correlation (0.733). And between PLT with RBC, HGB and HCT, as it was positive correlation (0.625, 0.574 and 0.575), respectively. Also there were correlation in NEUT with both WBC and LYM, as it were positive and inverse correlation (0.969 and -0.555), respectively. There was correlation between PDW and RDW, as it was positive correlation (0.622). There was correlation at between PCT with RBC, HGB with HCT, as it was positive correlation (0.654, 0591 and 0.574), respectively. Correlation also had been seen between Age and BNP, as there was inverse correlation (- 0.527). Also there were correlation between CRP and both TG, and creatinine, as there was positive correlation (0.731, 0.894). While there was correlation between CRP with HDL, LDL, and Urea, as there were inverses and positive correlation (- 0.505, -0.505 and 0.664), respectively. There was correlation between Creatinine with TG and correlation between Glucose with Weight, as there was positive correlation (0.763, 0.593), respectively.
The conclusions of the study were the most common bacterial species that causes infection to heart failure was Staphylococcus hominis ssp hominis, and meropenem had resistance to the most bacterial present.