摘要
目的探讨住院患者血流感染(Bloodstream infection,BSI)的病原菌和临床特点及死亡相关因素。方法回顾性研究医院2016年1月-2016年12月住院患者血培养阳性标本,共获得149例BSI患者,分析确诊为BSI的病原菌特点并分析患者临床资料,统计分析患者BSI死亡的相关影响因素。结果 149例患者共检出162株病原菌,其中革兰阴性菌95株占58.64%、革兰阳性菌59株占36.42%、真菌8株占4.94%;病原菌检出最多的科室为重症监护室39株,其次为烧伤科22株;Logisitic多元回归分析结果显示,入住EICU病区是导致BSI患者死亡的独立影响因素[OR=3.105,95%CI=(0.998~9.659),P=0.050];革兰阴性菌感染患者的C-反应蛋白(CRP)、降钙素原(PCT)均高于革兰阳性菌感染患者(P<0.05)。结论应加强对引起BSI患者的病原菌监测,结合患者临床特征,为临床医生经验性使用抗菌药物提供参考,以改善BSI患者的预后。
OBJECTIVE To investigate the distribution, clinical characteristics and death related risk factors of pathogenic microorganisms in patients with bloodstream infections （BSI）. METHODS Clinical data of 149 BSI pa- tients with culture-positive sepsis were collected from Ningbo No.2 Hospital from Jan. 2014 to Dec. 2014 for retro- spective study, bloodstream infection （BSI） events were identified and the epidemiotogy data were collected and of related factors of BSI death in patients were statistically analyzed. RESULTS A total of 162 strains of pathogens were detected from 149 patients,including 95 （58.64~/~） strains of gram-negative bacteria, 59 （36.42~/~） strains of gram-positive bacteria, and 8 （4.94%） strains of fungi. According to departments of BSIs, 39 strains were from ICU, and 22 strains were from the burn unit. Multivariate logisitic regression analysis showed that admission to the EICU ward was an independent factor leading to the death of BSI patients [OR = 3.105, 95 % C[ = （0.998 9.659）, P=0.050]. The C-reactive protein and PCT levels of gram-negative bacteria infection group were higher than those of gram-positive infection group （P〈0.05）. CONCLUSION Clinicians could strengthen the monitoring of pathogenic bacteria in patients with BSI, and use antibacterial drugs rationally combining with clinical features of patients to improve the BSI patient outcome.
作者
杨小平
许小敏
陈琳
蔡挺
胡耀仁
YANG Xiao-ping;XU Xiao-min;CHEN Lin;CAI Ting;HU Yao-ren(Ningbo No.2 Hospital, Ningbo, Zhejiang 315010, China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2018年第8期1154-1157,共4页
Chinese Journal of Nosocomiology
基金
浙江省自然科学基金资助项目(LY13H190008)
浙江省区域专病中心(感染科)建设学科基金资助项目(2014-98)
关键词
BSI
病原菌
死亡
相关因素
Bloodstream infection
Pathogenic bacteria
Death
Risk factor
