Risk factors analysis on sepsis complicated with hepatic insufficiency in elder patients / 中国医师进修杂志

Objective To explore the risk factors of sepsis complicated with hepatic insufficiency in elder patients.Methods With retrospective case-control study method,according to whether or not complicated with hepatic insufficiency,a total of 384 elder sepsis patients were divided into case group (91 patients) and control group(293 patients),then single factor analysis and multiple factors Logistic regression methods were used to screen the risk factors.Results Single factor analysis identified 6 kinds of significant variables,including age(P =0.000),history of alcohol(P =0.006),chronic diseases(P =0.001),arterial blood lactate level (P =0.035),mechanical ventilation (P =0.009) and acute physiology and chronic health evaluation Ⅲ score (APACHE-Ⅲ) scores(P =0.004).Multiple factors Logistic regression analysis showed that age,history of alcohol,chronic diseases,arterial blood lactate level,mechanical ventilation,APACHE-Ⅲ scores were correlated with sepsis complicated hepatic insuffciency in elder patients (P ＜ 0.01 or ＜ 0.05).Conclusion The risk factors which closely relate to sepsis complicated with hepatic insufficiency in elder patients are age,history of alcohol,chronic diseases,arterial blood lactate level,mechanical ventilation,APACHE-Ⅲ scores.

Detection of Proteus and Analysis of Drug-resistance in Intensive Care Unit / 医学研究杂志

Objective To detect the proteus and analyze the drug-resistance in intensive care unit.Methods From Jan 2005 to Dec 2006,proteus was detected by Disc diffusion test(K-B method)to study the antimicrobial resistance in ICU and general ward,and compared the drug-resistance.Results The isolating rate of proteus was 80.9% in sputum,and proteus mirabilis accouted for 80.4%.The resistance rates to ciprofloxacin,amikacin,cefotaxim,ceftazidime,cefmetazole and piperacillin/Tazobactam were between 64%~77%,and 32%~41% in imipenem and cefoperazone/sulbactam.Compared with general ward,the antibiotic resistant rate existed significant difference.And the antibiotic resistant rate of other type proteus had significant difference between ICU and general ward.Conclusion Properly detecting Proteus in time is imporrant to use antibiotic and to avoid nosocomial outbreak infections by Proteus.