Analysis on risk factors of Gram-negative bacterial blood-stream infection in ICU / 重庆医学

ABSTRACT

Objective To analyze the risk factors of Gram‐negative bacterial blood‐stream infection in ICU for conducting the risk evaluation and guiding medication .Methods The inpatients were diagnosed with Gram‐negative bacterial blood‐stream infec‐tion in ICU of the Renmin Hospital of Wuhan University from January 2013 to December 2014 were retrospectively surveyed and analyzed .The risk factors of blood‐stream infection caused by Gram‐negative bacteria were analyzed and screened by the Logistic re‐gression analysis method .Results A total of 172 case‐times of blood‐stream infection occurred in ICU during this period ,including 93 case‐times of Gram‐negative bacterial infection .The Gram‐negative pathogenic bacteria were Acinetobacter baumanii ,Klebsiella pneumoniae ,Acinetobacter calcoaceticus baumanii ,E .coli ,pseudomonas aeruginosa ,etc .Except E .coli was mainly originated from community acquired infection ,other bacteria were mainly originated from nosocomial infection .In order to differing from other pathogenic bacterial blood stream infection ,the Logistic regression analysis results showed that the independent risk factors of G‐negative bacterial blood‐stream infection in ICU had serum PCT levels over 10 .0 ng/mL (OR= 60 .52 ,P= 0 .001) ,receiving the therapy of carbapenem and third generation cephalosporins (OR=16 .09 ,P=0 .03) ,hospitalization duration less than 2 weeks be‐fore suffering from disease (OR=13 .79 ,P=0 .03) and digestive system basic disease(OR=12 .94 ,P=0 .01) .Conclusion Gram‐negative bacterial blood‐stream infection in ICU of the Renmin Hospital of Wuhan University is mainly caused by multi‐drug resist‐ant bacteria .Serum PCT level over 10 .0 ng/mL ,hospitalization duration less than 2 weeks before infection ,receiving the therapy of carbapenem and third generation cephalosporin and basic diseases of digestive system are the independent risk factors influencing the occurrence and diagnosis of blood‐stream infection .