Study On The Correlation Between The Characteristics Of Etiological Distribution And Severity,Inflammation Index And Coagulation Index Of Patients With Sepsis Caused By Bloodstream Infection

Objective:1.Analyze the distribution characteristics of pathogenic bacteria in patients with sepsis caused by bloodstream infection;2.To investigate the difference of severity,inflammation and coagulation indexes in patients with blood stream infection sepsis with different bacterial communities;3.To investigate whether there is correlation among severity,inflammation indexes and coagulation indexes of patients with bloodstream infection sepsis,so as to provide theoretical basis and guiding opinions for early prediction of patients with bloodstream infection sepsis and rational use of antibiotics.Methods:Thirty-nine sepsis patients with positive blood culture in the ICU of Ningxia Hui Autonomous Region People’s Hospital from January 2017 to February 2020 were retrospectively collected.The characteristics of their etiological distribution were analyzed.According to the etiological results,they were divided into groups:Gram-negative bacteria group,Gram-positive bacteria group,and fungi group.Comparison of three groups of subjects degree of general situation,severity(acute physiology and chronic health evaluation(APACHEⅡscore),sequential organ failure score(SOFA score),inflammation index(procalcitonin(PCT)and c-reactive protein(CRP)and white blood cell count(WBC)),coagulation index(platelets(PLT),part of the activation of prothrombin time(APTT),thrombin time(TT),fibrinogen(FIB)and D-dimer(D-D))levels.Correlation statistical methods were used to analyze the correlations among severity,inflammatory indexes and coagulation indexes.Results:1.Distribution characteristics of pathogenic bacteria:a total of 49 strains of pathogenic bacteria were detected in 39 patients,including 22 strains of Gram-negative bacteria(44.90%),17 strains of Gram-positive bacteria(34.69%),and 10 strains of fungi(20.41%).2.The general situation of three groups of subjects,severity,inflammation,blood clotting comparison:general situation of three groups of objects,acute physiology and chronic health evaluation(APACHEⅡscore),sequential organ failure score(SOFA score)had no difference(P>0.05);There was significant difference in PCT between the gram-negative bacteria group and the fungi group(P<0.05);There was significant difference in PLT between the gram-negative bacteria group and the fungi group(P<0.05);3.Correlation analysis results:There was a negative correlation between PCT and PLT in sepsis patients with bloodstream infection(r_s=-0.430,P<0.05),PCT was positively correlated with D-D(r_s=0.333,P<0.05);CRP was positively correlated with FIB(r_s=0.377,P<0.05);WBC was negatively correlated with APTT(r_s=-0.293,P<0.05),WBC was positively correlated with D-D(r_s=0.381,P<0.05).Bloodstream infections in patients with sepsis in the APACHEⅡscore and PCT,TT were positively correlated(r_s=0.341,P<0.05;r_s=0.365,P<0.05),was negatively correlated with PLT(r_s=-0.373,P<0.05);SOFA score was positively correlated with PCT and TT(r_s=0.407,P<0.05;r_s=0.370,P<0.05),was negatively correlated with PLT(r_s=-0.601,P<0.05).Conclusion:1.The pathogenic bacteria of patients with sepsis caused by bloodstream infection were mainly Gram-negative bacteria;2.There was no difference in severity of sepsis patients infected with different bacterial flora in blood stream;Gram-negative bacteria infection caused more severe inflammation than fungal infection,and the effect on the PLT of coagulation function was more obvious;3.The inflammatory response of patients with bloodstream infection sepsis is correlated with the coagulation function;4.The severity of patients with bloodstream infection with sepsis is correlated with PCT in the inflammatory indicators and PLT and TT in the coagulation indicators.The changes in the condition of patients with sepsis can be reflected by monitoring the levels of PCT,PLT and TT.