Analysis Of Prognostic Risk Factors Among Gram-positive Cocci Bloodstream Infection Patients In ICU

Objective To investigate the prognostic risk factors of patients with hospitalacquired bloodstream infection(BSI) caused by Gram-positive Cocci in ICU.Methods Retrospectively analysis of clinical data of patients, admitted to ICUfrom January2010to December2011and diagnosed Gram-positive Cocci BSI, wasperformed. Patients were divided into survivor and non-survivor groups according tothe clinical outcomes. Comparison of Physiological and laboratory parametersbetween two groups, collected within24hours once BSI occurred, was launched.Logistic regression was used to analyze the prognostic risk factors of BSI.Results Blood cultures of61samples from57patients showed positive cocci BSIwithin2years, among of them,23patients dead(40.35%)and34cases(59.65%)survived.61blood samples were composed by Staphylococcus Epidermidis20cases(32.79%), Staphylococcal Hominis18cases(29.51%), Enterococcus Faecium8cases(13.11%), Staphylococcus Hemolyticum6cases(9.84%), Staphylococcus Xylosus5cases(8.20%) and Staphylococcus Aureus4cases(6.56%). Univariate analysis indicatedthat body temperature(P=0.009), central venous pressure (CVP)(P=0.000), APACHE IIscore(P=0.000), platelet count(P=0.030), blood urea nitrogen (BUN)(P=0.015), serumcreatinine(P=0.023) and serum sodium(P=0.041) were statistically significant betweentwo groups (P<0.05), whereas no significances in age, gender and length of stay inICU(P>0.05) were detected. Multivariate logistic regression suggested APACHE II (OR0.68,95%CI0.51～0.89; P=0.005), CVP (OR1.62，95%CI1.12～2.33; P=0.010) andserum sodium (OR0.70,95%CI0.54～0.97; P=0.007) be the independent risk factorsfor death of Gram-positive Cocci BSI patients in ICU.Conclusion The prognosis of patients diagnosed Gram-positive Cocci BSI may besignificantly associated with disease severity and CVP level. Meanwhile, dynamicmonitoring of CVP has an important clinical significance.