Clinical Study On Factors Influencing The Prognosis Of Patients With Traumatic Bloodstream Infection

Objective: To investigate the clinical features and prognostic factors of patients with traumatic bloodstream infection.Objective: to investigate the effect of biofilm formation and drug resistance on the prognosis of pathogenic bacteria of fungal bloodstream infection.It provides reference for prevention and control of bloodstream infection in trauma patients.Methods: A retrospective method was used to analyze the clinical data of 110 patients with traumatic bloodstream infection admitted to the Department of Intensive Medicine of Daping Hospital from January 2012 to December 2017.Gender,age,injury score and other general clinical data and mechanism of injury,hospitalization time,ventilator use time,enteral nutrition development time,hospitalization mortality rate,bloodstream infection pathogens and drug resistance were collected.Collect pathogenic bacteria combined with fungal infection-80 ? frozen specimens,in vitro drug susceptibility experiments to understand their drug resistance,and analysis of biofilm formation ability.Results: A total of 110 cases were included in this study.Most of themen were 93,accounting for 84.5%,with an average age of 50.1 years,and an average ISS score of 22.3.The main injury mechanism was 46 road traffic injuries,accounting for 41.8%,followed by It was a fall injury from a height of 31 cases,accounting for 28.2%.The average hospital stay was45.0(35.0,66.2)days,and there were 5 deaths,accounting for 4.5%.The elderly group had a higher percentage of fall injuries than the young group,P<0.05;compared with the early EN group(enteric nutrition given within48 hours after surgery).The delayed EN group(enteric nutrition given after48 hours after surgery)The death rate of patients is higher,P value<0.05.The incidence of abdominal distension is higher,P value <0.05.the hospitalization time of severely injured patients with ISS ? 25 points,ICU hospitalization time is longer and longer,Compared with non-severe injuries,the P value was <0.05,which was statistically significant.The ICU stay in the catheter-related bloodstream infection catheter-related group was 22(11,26)days,and the non-catheter-related group was 15(11,24)days.P value = 0.038,the difference was statistically significant;for multi-drug resistant bacteria,the P value <0.05 was statistically different between the two groups;the number of deaths was 5 in the catheter-related group and 0 in the non-catheter-related group,with a P value <0.05.According to whether they are resistant to fluconazole,the collected Candida can be divided into fluconazole-resistant group and fluconazole-sensitive group.The resistance group biofilm formation abilityOD value: 0.73 ± 0.08,sensitive group biofilm formation ability OD value:0.34 ± 0.18,the comparison between the two is P <0.05,.According to the clinical prognosis,it was divided into a death group and a survival group.The OD value of candida biofilm formation ability in the death group was0.77 ± 0.03,and the OD value of biofilm formation ability in survival group was 0.38 ± 0.20.Conclusion:1.The prognosis of patients with traumatic bloodstream infection is related to the severity of the injury,nutrition support strategy,and source of infection.2.The increased fungal biofilm formation ability leads to higher drug resistance,which may be one of the reasons for the increased risk of death in patients with traumatic infection.