Study On The Current Situation And Direct Economic Burden Of Central Catheter-related Bloodstream Infection In A Tertiary Hospital

Objective:through the study of a tertiary hospital from January 201 5 to December 201 9,floor occurs during the Central catheter-related Bloodstream Infections(Central LineAssociated Bloodstream Infections,CLABSI)of the status quo and CLABSI on hospitalization expenses and the influence of such confinement,exploration and partial CLABSI independent risk factors of patients,improve the clinical medical staff awareness of CLABSI,scientific prevention and control measures,so as to reduce the incidence of CLABSI,reduce the direct economic loss of patients.Methods:this study retrospectively investigated 17,926 patients with central catheter in a tertiary hospital from January 2015 to December 2019,among whom 87 patients had central catheter-related bloodstream infections.Designed according to the need of the vast literature at home and abroad and referring to the clinical departments catheter in patients with general condition questionnaire "and" questionnaire of hospitalization expenses for patients with clinical departments catheter,patients in the basic information of the cases,infection department,and time,pathogens,and basic diseases,invasive operation and hospitalization expenses,etc.Patients with CLABSI were assigned to the CLABSI group,and patients with concurrent catheterization and no infection were assigned to the Non-CLABSI group.Chi-square test and Logistic regression analysis were used to explore the independent risk factors of CLABSI,the distribution of clinical characteristics,the distribution of major pathogens and drug resistance of CLABSI patients during hospital stay.ln the non-clabsi group,patients in the CLABSI group were matched according to the 1:1 matching principle to form a control group,and the influence of CLABSI on hospitalization cost and length of stay was explored through the matching rank sum test.All the data were set up with Microsoft Office Excel 2010,and the statistical software SPSS 24.0 was used for data analysis.Results:1.Among the 17,926 patients who met the standard of central catheter catheterization,the oldest patient was 95 years old,and the youngest one was 1 year old,with an average age of(54.19±17.496)years old.There were 9,931 male patients(55.4%)and 7,995 female patients(44.6%).There was no significant difference in age and gender composition between CLABSI group and Non-CLABSI group(P>0.05).2.In the distribution of catheterization sites,the most catheterization sites were PICC,followed by subclavian vein,followed by femoral vein,and the least catheterization sites were internal jugular vein.The infection rate of the four sites was ranked from high to low:femoral vein>internal jugular vein>subclavian vein>PICC.3.Diabetes,frequency of ventilator use≥3,number of ICU admission and the type of antibacterial agents used in combination was≥3 are independent risk factors for CLABSI,while PICC catheterization is a protective factor relative to other sites.4.The top three departments for the incidence of CLABSI were ICU,neurosurgery and hematology,with the highest incidence in the third quarter of each year.5.The main pathogenic bacteria of CLABSI patients were mainly gram-negative bacteria,and the drug resistance rates of klebsiella pneumoniae and acinetobacter baumannii were higher.6.Compared with the control group,the average length of stay of CLABSI patients was 10 days.7.Compared with patients in the control group,the direct economic loss of CLABSI was 120,764 yuan,of which the first three were western medicine fee(29,749 yuan),material fee(8,151 yuan)and treatment fee(6,486 yuan).Western medicine fee,material fee and treatment fee are the main components of direct economic loss of CLABSI patients.8.In ICU,compared with patients in the control group,the direct economic loss caused by CLABSI patients was 94,922 yuan,of which the first three were western medicine fee(39,273 yuan),treatment fee(15,098 yuan)and laboratory fee(5,139 yuan).9.The median hospitalization cost of patients with CLABSI in ICU is 187,076 yuan more than that of patients with CLABSI in general departments.According to the rank-sum test,except that there was no statistically significant difference between the cost of traditional Chinese medicine and other costs,the former cost was more than the latter.10.The direct economic loss caused by different age groups is different,among which,the direct economic loss caused by CLABSI patients aged ≥60 years old is the largest,which is 11,0506 yuan and the length of hospitalization is extended for 14 days.Conclusion:1.Diabetes mellitus,frequency of ventilator use ≥3,ICU admission and the type of antibacterial agents used in combination was ≥3 are independent risk factors for CLABSI.2.The main pathogenic bacteria of CLABSI patients were mainly gram-negative bacteria,and the drug resistance rates of klebsiella pneumoniae and acinetobacter baumannii were higher.3.The average hospital stay of CLABSI patients was extended by 10 days,resulting in a direct economic loss of 120,764 yuan.4.Severe direct economic losses to patients with CLABSI in ICU and CLABSI patients aged ≥60 years.