ABSTRACT
Objective To investigate the risk factors and prognostic factors of bloodstream infection in intensive care unit(ICU). Methods The data of patients with bloodstream infection in ICU of Harrison International Peace Hospital from October 2014 to October 2017 were retrospectively analyzed and 210 patients with negative blood culture were selected. The physiological and laboratory parameters were compared between patients with positive blood culture and those with negative blood culture. Multivariate logistic regression analysis was used to screen the risk factors of bloodstream infection. Overall, 189 patients with bloodstream infection were classified into survival group(n=121)and death group(n=68)according to the survival status within 30 days after blood culture. The risk factors related to 30-day patient outcome following bloodstream infection were analyzed. Results A total of 189 cases of bloodstream infection were identified in the ICU during the 3-year period, including 118 cases due to gram-negative bacilli, 65 cases caused by gram-positive cocci, and 6 cases due to fungi. Univariate analysis showed that prior use of carbapenem or third generation cephalosporins, central venous catheterization, length of hospital stay≥2 weeks, and mechanical ventilation were the risk factors of bloodstream infection(P<0.05). Multivariate logistic regression analysis showed that prior use of carbapenems or third-generation cephalosporins(OR=20.15), central venous catheterization(OR=25.34), and mechanical ventilation(OR=18.26)were independent risk factors for bloodstream infection in ICU patients. Univariate analysis showed that prior use of carbapenem or third generation cephalosporins, mixed infection or septic shock, multi-drug resistant bacterial infection, and high APACHE Ⅱ(acute physiological and chronic health evaluation system Ⅱ)score were significant risk factors for 30-day mortality following bloodstream infection(P<0.05). Multivariate logistic regression analysis showed mixed infection or septic shock(OR=15.30), multi-drug resistant bacterial infection(OR=10.75)and high APACHE Ⅱ score(OR=13.70)were independent risk factors for 30-day mortality following bloodstream infection. Conclusions Prior use of carbapenem or third generation cephalosporins, central venous catheterization and mechanical ventilation are independent risk factors for bloodstream infection in ICU patients. Mixed infection or septic shock, multi-drug resistant bacterial infection, and high APACHE Ⅱ score are independent risk factors for 30-day mortality following bloodstream infection.