A Retrospective Clinical Study On Bloodstream Infection In ICU And Related Health Economics Analysis

ObjectiveTo explore the current situation,pathogenic characteristics and related risk factors of bloodstream infection in the intensive care unit(ICU)of our hospital,and to explore the economic losses caused by bloodstream infection to patients,to take further measures to control the infection,reduce the burden of disease to provide a scientific basis.MethodsThis study was a retrospective study and included all patients who were hospitalized in the Intensive Care Unit(ICU)of the General Hospital of Ningxia Medical University from January 1,2016,to December 31,2018,and all patients who received blood culture specimens were examined.In the clinical analysis of bloodstream infection,176 patients with positive blood culture were divided into the survival group and death group according to the28-day prognosis.In the stage of analysis of economic loss,a case-control study was used to compare 176 patients with blood culture positive with 1560 blood cultures.Negative patients were matched according to the 1: 1 case ratio.Finally,69 patients from the infection group and the control group were matched for economic analysis.Fill out the relevant questionnaires for all included subjects.Results1.A total of 214 pathogens were isolated from blood cultures of 176 patients with bloodstream infection,and there were multiple bacterial infections.Among them,122 strainsof Gram-negative bacteria(57.0%),74 strains of Gram-positive bacteria(34.6%),and 18 other pathogens(8.4%).The common pathogens are in turn 42 strains of Escherichia coli(23.9%),23 strains of Klebsiella pneumonia(13.1%),15 strains of Enterococcus faecium(8.5%),12 strains of Acinetobacter baumannii(6.8%),12 strains of S.aureus(6.8%),12 strains of Bacteroides(6.8%),10 strains of Candida(5.7%),and so on.2.The single-factor analysis showed that: suffering from cardiovascular and cerebrovascular diseases,mechanical ventilation,central venous catheterization,blood purification,WBC,PLT,LAC,CREA,PCT values in laboratory indicators,APACHE ?score and SOFA score,blood culture was Enterococcus faecium,the length of hospital stay and the number of days of ICU stay was 14 risk factors for death in patients with bloodstream infection in ICU(P <0.05).3.Multivariate Logistic analysis results showed that WBC,APACHE ? score,and SOFA scores were independent risk factors for death in patients with ICU bloodstream infection(P <0.05).4.In the analysis of the economic burden of disease,the survival rate of patients with bloodstream infection is lower than that of non-bloodstream infected patients(P <0.05);patients with bloodstream infection live in ICU longer than patients with non-bloodstream infection(P <0.05);patients with bloodstream infection from hepatobiliary surgery have significantly shorter ICU stay time(P <0.05),and ICU stay cost is reduced(P <0.05);there is no significant difference in the cost of ICU for patients with bloodstream infection and non-bloodstream infection.Conclusion1.The main pathogens of ICU bloodstream infection in our hospital are Gram-stained negative bacteria.2.ICU bloodstream infections can prolong the hospital stay of patients and increase mortality.The bloodstream infection in this group does not affect the increase or decrease ofICU hospitalization costs.