ANALYSIS OF PROGNOSTIC RISK FACTORS OF BLOODSTREAM INFECTIONS IN BEIJING COMMUNITIES: A RETROSPECTIVE STUDY FROM 2015 TO 2019
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Keywords
community-onset bloodstream infection (COBSI), China; Beijing, retrospective study, epidemiology
Abstract
Objective: This study intends to investigate the prognostic risk factors of bloodstream infection in Beijing. Methods: This study is a clinical retrospective study. Patients with community-onset bloodstream infections (COBSI) who were admitted to the emergency department and inpatient department of Beijing Jishuitan Hospital from January 1,2015 to December 31,2019 were selected as the main research objects. According to whether the patient survives for 100 days or not, the patients are divided into survival group and death group. By analyzing the clinical data of the two groups of patients, the epidemiology, clinical characteristics, bacterial resistance and risk factors affecting the prognosis of the patients were analyzed. Results: A total of 446 patients with COBSI diagnosed by blood culture were included in this study, including 252 men and 194 women. According to 100-day survival or not, patients were divided into survival group and death group, of which 363 cases were in the survival group and 83 cases were in the death group. The results of this study show that solid tumors, combined septic shock, indwelling catheters and hemodialysis treatment are independent risk factors affecting the prognosis of COBSI patients. Reasonable initial antibiotic therapy is a protective factor affecting the prognosis of COBSI patients. Conclusion: Solid tumors, combined septic shock, indwelling catheters, hemodialysis treatment, Charlson score, APACHE II score and PITT score are independent risk factors affecting the prognosis of COBSI patients in Beijing, the capital of China, and reasonable initial antibiotic therapy is a protective factor affecting the prognosis of COBSI patients.
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References
2.A C H Y , B Y C H , C Y L W , et al. Clinical predictors and outcome impact of community-onset polymicrobial bloodstream infection. International Journal of Antimicrobial Agents, 2019, 54( 6):716-722.
3.Mao S , Ge Z , Zhao H , et al. Analysis on distribution and drug resistance of pathogen caused community-onset bloodstream infection. Zhonghua w zhong bing ji jiu yi xue, 2019, 31(1):67-72.
4.Jean-François Timsit., Etienne Ruppé., et al. Bloodstream infections in critically ill patients: an expert statement.. Intensive Care Med 2020;46(2):266-284.
5.Ministry of Health in China．Diagnostic criteria for nosocomial infections(proposed).Natl Med J china，2001，81(5)：314—320．
6. Anderson DJ, Moehring RW, Sloane R, et al. Bloodstream infections in community hospitals in the 21st century: A multicenter cohort study. Plos One Planet P J , ed. 2014; 9:e91713
7. Pereira CAP, Marra AR, Camargo LFA, et al. Nosocomial bloodstream infections in Brazilian pediatric patients: microbiology, epidemiology, and clinical features. PLoS One. 2013;8:e68144.
8. Anderson DJ, Moehring RW, Sloane R, et al. Bloodstream infections in community hospitals in the 21st century: A multicenter cohort study. Plos One Planet P J , ed. 2014; 9:e91713.
9. Bates DW, Pruess KE, Lee TH. How bad are bacteremia and sepsis? Outcomes in a cohort with suspected bacteremia. Arch Intern Med. 1995;155(6):593–8.
10. Laupland KB, Gregson DB, Flemons WW, Hawkins D, Ross T, Church DL. Burden of community-onset bloodstream infection: a population-based assessment. Epidemiol Infect. 2007;135(6):1037–42.
11. Xinliang,Hanxiao. Clinical characteristics and pathogen profile in 193 cases of community acquiredbloodstream infection Chin J Infect Chemother, January 2019, 19(1):6-11
12. Yanxiong, Hongzhang,Yantianchen,Yongzhangrong. Investigation on the distribution of pathogenic bacteria from community and hospital acquired blood current infection and their routes of infectionLaboratory Medicine， 2014，20(10):1007-1012.
13. M A Reza, M Cormican Irish journal of medical science 2017 Nov;186(4):999-1001.
14. Laupland K B , Svenson L W , Gregson D B , et al. Long-term mortality associated with community-onset bloodstream infection. Infection, 2011, 39(5):405-410.Ching Jou Lim, Allen C Cheng, et al. BMC infectious diseases 2014 Mar 04;14:126.
15. Loonen AJM, de Jager CPC, Tosserams J, et al. Biomarkers and molecular
analysis to improve bloodstream infection diagnostics in an emergency
care unit. PLoS One. 2014;9:e87315.
16.ARNAN M， GUDIOL C， CALATAYUD L， et al. Risk factors for, and clinical relevance of, faecal extended-spectrum β-lactamase producing Escherichia coli (ESBL-EC) carriage in neutropenic patients with haematological malignancies. Eur J Clin Microbiol Infect Dis，2011，30(3):355–360.
17.Betjes MG. Immune cell dysfunction and inflammation in endstage renal disease . Nat Rev Nephrol, 2013, 9 (5): 255-265.
18.Janina Z , Hartwig K , Anna K , et al. Epidemiology of Candida blood stream infections in patients with hematological malignancies or solid tumors. Medical Mycology, 2012, 50(1):50-55.
19.Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock: 2016. Crit Care Med. 2017;45(3):1–67.
20.Lin MY, Weinstein RA, Hota B. Delay of active antimicrobial therapy and mortality among patients with bacteremia: impact of severe neutropenia. Antimicrob Agents Chemother. 2008;52(9):3188–94.
21.Corona A, Bertolini G, Lipman J, Wilson AP, Singer M. Antibiotic use and impact on outcome from bacteraemic critical illness: the BActeraemia Study in Intensive Care (BASIC) J Antimicrob Chemother. 2010;65(6):1276–85.
22. Ibrahim EH, Sherman G, Ward S, Fraser VJ, Kollef MH. The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting. Chest. 2000;118(1):146–55.
23. Lee CC, Lee CH, Chuang MC, Hong MY, Hsu HC, Ko WC. Impact of inappropriate empirical antibiotic therapy on outcome of bacteremic adults visiting the ED. Am J Emerg Med. 2012;30(8):1447–56.
24. Chen HC, Lin WL, Lin CC, Hsieh WH, Hsieh CH, Wu MH, et al. Outcome of inadequate empirical antibiotic therapy in emergency department patients with community-onset bloodstream infections. J Antimicrob Chemother. 2013;68(4):947–53.
25. Leibovici L, Shraga I, Drucker M, Konigsberger H, Samra Z, Pitlik SD. The benefit of appropriate empirical antibiotic treatment in patients with bloodstream infection. J Intern Med. 1998;244(5):379–86.
26. Kumar A. An alternate pathophysiologic paradigm of sepsis and septic shock: implications for optimizing antimicrobial therapy. Virulence. 2014;5(1):80–97.
27. María Paz Vaquero-Herrero, Silvio Ragozzino, et al. The Pitt Bacteremia Score, Charlson Comorbidity Index and Chronic Disease Score are useful tools for the prediction of mortality in patients with Candida bloodstream infection.Mycoses 2017;60(10):676-685.
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