Clinical Distribution Of PICU Multi-drug Resistant Gram-negative Bacteria And Analysis Of Risk Factors Of Bloodstream Infection

Objective:To investigate the clinical distribution characteristics of(PICU)multi-drug resistant Gram-negative bacteria(MDR-GNB)in pediatric acute and critical intensive care unit(ICU),and to explore the risk factors and prognostic factors of MDR-GNB bloodstream infection.Methods:A total of 106 patients with MDR-GNB admitted to the Urumqi City some three A hospital(hereinafter referred to as "our hospital")from September 2017 to September 2019 were selected and divided into MDR-GNB bloodstream infection group and non-bloodstream infection group by single center and retrospective study.The distribution characteristics of MDR-GNB strains in bloodstream infection were statistically analyzed.Logistic multivariate regression analysis was used to explore the risk factors of MDR-GNB bloodstream infection and the related risk factors affecting prognosis.Results:1)The top five strains of MDR-GNB bloodstream infection in PICU were multidrug-resistant Acinetobacter baumannii(MDRAB),multidrug-resistant Pseudomonas aeruginosa(MDRPA),extended-spectrumβ-lactamase-producing Klebsiella pneumoniae(ESBLKP),extended-spectrumβ-lactamase-producing Escherichia coli(ESBL E.coli),and multidrug-resistant Pseudomonas maltophilia(SMA).2)Univariate analysis showed that there were significant differences in age,liver function insufficiency,tumor disease,hematological disease,central venous catheterization,immunosuppressant and operation history within 30 days before infection between MDR-GNB bloodstream infection group and non-bloodstream infection group.3)Multivariate logistic regression analysis showed that liver insufficiency,neoplastic disease,digestive system disease and history of operation within 30 days before infection were independent risk factors for MDR-GNB bloodstream infection(OR=2.609,4.569,2.803,4.001,respectively).4)Univariate analysis showed that there were significant differences in tumor disease,digestive system disease,traumatic disease,invasive mechanical ventilation and operation history within 30 days before infection between the two groups(P<0.05).(5)Logistic regression analysis showed that tumor disease,invasive mechanical ventilation and operation history within 30 days before infection were independent factors affecting the prognosis of MDR-GNB bloodstream infection(OR=9.612,14.796,0.075,respectively).Conclusion:The detection rate of MDRAB in MDR-GNB with PICU bloodstream infection is the highest.The risk of MDR-GNB bloodstream infection is increased due to liver insufficiency,tumor disease,digestive system disease and the history of operation within 30 days before infection.Neoplastic disease.Invasive mechanical ventilation and surgical history within 30 days before infection are independent factors affecting the prognosis of MDR-GNB bloodstream infection.To understand the clinical distribution and risk factors in order to guide clinical treatment and improve prognosis.