Bloodstream Infections In Patients With Risk Factors For Symptom Analysis And TCM

BackgroundBloodstream infection is one of infectious complications in patients hospitalized during the more important. In recent years, due to the large doses of immunosuppressive drugs and chemotherapy drugs, especially in patients admitted to the ICU in critical condition and more needs to intravascular catheters implanted, resulting in bloodstream infections in the global incidence increased year by year, and the detection rate of drug-resistant strains increased year by year to become one of the causes of death in many critically ill patients. Analyzing the dangerous factors in patients with bloodstream infections and studying such patients’ elements and combinations syndromes law to provide a theoretical basis for the differential treatment of bloodstream infections, looking for effective treatments of traditional Chinese medicine, has a certain significance.ObjectiveA retrospective survey of patients with bloodstream infections characteristics, blood-borne infection in our hospital pathogens constitute major strains of drug-resistant cases, investigating the impact of patient prognosis and dangerous factors for drug-resistant strains, providing reference for clinical prevention and treatment. Understanding the distribution of TCM syndrome elements, for Chinese medicine to provide a scientific basis for intervention symptoms.MethodsTaking the way of A retrospective survey records, collecting blood-borne infection in the patient’s clinical information, counting distribution and drug resistance strains, according to whether the drug, the prognosis is grouped separately, comparing the difference between the various groups of related factors, determine possible dangerous factors. Patients also recorded the basic TCM syndrome elements composition according to electronic medical records.Results80cases of blood-borne infection were Included, which Died49cases (accounting for61.3%) and survived31cases (accounting for38.7%).80patients were grouped based on susceptibility results, where resistance group (including multi-drug resistance, pan-resistant, full resistance)47cases (58.7%),33cases of non-resistance group (41.3%). Risk factors impacting the prognosis of patients are investigated and finding ICU patients hospitalized for a few days, APACHEII score, serum immunoglobulins, serum albumin, serum creatinine, blood urea nitrogen, total bilirubin values, the number of rows of CRRT, invasive mechanical ventilation, heart failure, high-sodium and high chloride have statistically significant difference between the two groups compared, but only APACHE II score, serum immunoglobulin inspection passed the regression equation. Comparing of the clinical features of drug resistance and non-drug resistance group,which includes the number of days patients ICU length of stay, the number of cases and the average number of treatments bronchoscopy line treatment, the number of cases and the average number of treatments CRRT treatment, carbapenem antibiotic use and use enzyme inhibitors for a few days, the number of third-generation cephalosporin use of time, the use of broad-spectrum penicillin time, azole antifungals time and has statistically significant between the two groups, and ultimately into the independent variable regression equation consist of carbapenem broad-spectrum penicillin use of time.Bloodstream infections with Gram-negative bacilli bacteria (57.8%). The first three pathogens were Acinetobacter baumannii, Escherichia coli, and Pseudomonas aeruginosa. In coagulase-negative staphylococci positive cocci detection rate is the highest (17.8).The investigation found that deficiency mixed is more common(65%) in TCM syndrome elements of80cases of bloodstream infections, Secondly purely empirical27.5%pure deficiency of5%. Qi Xu has the highest frequency in deficiency symptoms elements class, up to58.8%, with followed by Yang Xu(13.8%), Yin Xu(12.5%), anemia Xu(7.5%). Phlegm, blood stasis have the highest frequency in elements of class syndrome empirical, respectively up to71.3%and62.5%. The frequency of blood stasis syndrome in dead patients is higher than survival group. drug group deficiency, shui yin syndrome permit higher frequency of non-resistance group. The frequency of Qi Xu and shui yin in resistant drug patients is higher than non-resistant syndrome group. Conclusion1. High APACHEII score、Low immunoglobulin levels may independent dangerous factors that affect the prognosis of patients.2. If broad-spectrum penicillin and carbapenem antibiotics are used in long time, the resistant trend of blood-borne infections’ pathogens will rise.3. The detection rate of Acinetobacter baumannii is the first one in pathogens, which has higt resistant rate trends, so clinical prevention and control should be strengthened.4.deficiency mixed is more common in patients of blood-borne infections and Qi Xu, phlegm and blood stasis have highest frequency. Blood stasis in dead patients is more than survival group. Qi Xu and Shui Yin syndrome have high frequency in resistant drug group.therefore the deficiency and empirical should be taken into account in clinical, such as replenishing upright while strengthening Huo xue Hua yu, Wen Yang Hua Yin, and so on.