Epidemiological Analysis Of Sepsis-associated Liver Injury Of Related Infection Sites And Pathogens

Objective: Retrospective analysis of the infection sites and pathogens in patients with sepsis-assoociated liver injury from the department of Critical Care Medicine of our hospital.Analysis of epidemiological characteristics of pathogens isolated from related infection sites.Method: To analyze the clinical data of 138 patients with sepsis-assoociated liver injury admitted to the Intensive Care Unit(ICU)of our hospital between January 2016 and December 2017.The epidemiological characteristics of isolated pathogens were analyzed.The statistical method uses SPSS22.0 software.Result: In this statistic,Liver injury was divided into three subgroups,including high aminotransferase group,high bilirubin group and both high aminotransferase and bilirubin group.More men than women in the three subgroups.The gender ratios of the three subgroups were statistically significant(P<0.05).The number of patients aged ?60years old was 74 cases.The abdominal cavity was the most common site of infection,87(63.0%),followed by the lungs,38(27.5%).In the 138 patients,140 strains of pathogens were isolated,mainly Gram-negative bacteria(60%).Escherichia coli was the most,with22 strains.Escherichia coli,enterococcus faecalis and candida albicans were the most common negative bacteria,positive bacteria and fungi.Gram-negative bacteria were the main pathogenic bacteria isolated from the abdominal cavity and lung,escherichia coli and acinetobacter baumannii were the main negative bacteria in the abdominal cavity and lung.The three subgroups with sepsis-assoociated liver injury were mainly Gram-negative bacteria.Among them,the most common negative bacteria,positive bacteria and fungi in the high bilirubin group and the both high aminotransferase and bilirubin group were Escherichia coli,Enterococcus faecium and Candida albicans;the most common negative bacteria,positive bacteria and fungi in the high aminotransferase group were Acinetobacter baumannii.Staphylococcus aureus,Staphylococcus haemolyticus and Candida albicans.The mortality rate of patients with bacteremia or non-bacteremia in sepsis-assoociated liver injury during ICU was 48.98% and 30.34%.The mortality rate of patients with bacteremia was significantly higher than that of non-bacteremia patients.Statistical significance(P<0.05).Multivariate Logistic regression analysis was performed to analyze the factors that might affect the death of patients.Patients with sepsis-assoociated liver injury with bacteremia(OR=2.275,P<0.05),advanced age(OR=1.031,P<0.05),high SOFA score(OR=1.281,P<0.05)can increase the risk of death.Conclusion: 1.Patients with sepsis-assoociated liver injury are mostly patients with ?60years old,more male patients than female patients,and the gender ratios of different subgroups of liver injury are different.2.The abdominal cavity is the main infection site of patients with sepsis-assoociated liver injury,followed by the lungs.3.The pathogens involved in the infection site of sepsis patients with liver injury include Gram-negative bacilli,Gram-positive cocci,and fungi.Escherichia coli is the main pathogen.4.Clinical subgroup analysis of sepsis liver injury showed that Escherichia coli and Enterococcus faecium were the main negative bacteria and positive bacteria in the high bilirubin group and the both high aminotransferase and bilirubin group.Acinetobacter baumannii and Staphylococcus aureus and Staphylococcus haemolyticus are the main negative bacteria and positive bacteria in the high aminotransferase group.Candida albicans is the main subfamily of three subgroups.5 The mortality rate of patients with sepsis-assoociated liver injury and bacteremia was higher than that of non-bacteremia patients.6.Sepsis-assoociated liver injury with bacteremia,advanced age,high SOFA score is a risk factor for death.