Analysis Of Prognostic Factors Related To Hospital-acquired Infections Caused By Multi-drug Resistant Klebsiella Pneumoniae

Objective:By comparing the clinical characteristics,serological indicators and related factors of the survival group and the death group of patients with hospital-acquired infection caused by multi-drug resistant klebsiella,explore its risk factors related to prognosis and to raise awareness of multi-drug resistant klebsiella,reduce the infection rate in the hospital,improve the prognosis of patients,reduce the economic burden.Methods:A retrospective method was used to collect 3000 patients with Klebsiella pneumoniae infection in the First Hospital of Jilin University from August 2016 to October 2017.Among them,70 patients met the inclusion criteria,48 patients survived,and 22 patients died.For example,the characteristics of the two groups of patients in terms of age,gender,combined basic disease,invasive operation,hospitalization time,serological results,etc.were compared.Results:1.Basic situation of patients and distribution of departments: 70 patients with hospital-acquired infection caused by multi-drug resistant pneumonia were collected,including 48 cases of survival and 22 cases of death,with an average age of 63.66±12.82 years old,47 males and 23 females.The department is mainly distributed in the integrated ICU,oncology,respiratory,neurology,neurosurgery,and emergency medicine.2.Drug resistance: multi-drug resistant Klebsiella pneumoniae is highly resistant to penicillins,cephalosporins and quinolone antibiotics,and resistant to amikacin in hydrocarbonases and aminoglycosides.The minimum is 4.29%(3/70).3.Comparison of general conditions: There was no significant difference in gender,age,smoking,drinking,underlying disease,recent use of hormones and immunosuppressive agents,respiration,heart rate,blood pressure,and length of hospital stay between the two groups(P>0.05).).4.Comparison of invasive procedures: There was no significant difference in the retention of gastric tube,urinary catheter,deep vein and mechanical ventilation between the two groups(P>0.05).5.There were significant differences in white blood cell count,neutrophil count,neutrophil percentage,hemoglobin concentration,AST,cholinesterase,PCT,and BNP between the two groups(P<0.05).There was no significant difference in platelet,ALT,ALP,γ-GT,albumin,creatinine,urea,troponin and CRP(P>0.05).Univariate analysis suggested that white blood cell count,neutrophil count,neutrophil percentage,hemoglobin concentration,AST,cholinesterase,PCT,BNP may be associated with multi-drug-resistant Klebsiella pneumoniae hospital-acquired infection prognosis Related.6.The above relevant factors were included in the Logisitic regression analysis,suggesting that cholinesterase is an independent risk factor for hospital-acquired infection death caused by multidrug-resistant Klebsiella pneumoniae.Conclusions:1.Multi-drug resistant Klebsiella pneumoniae infection is mainly in middle-aged and elderly men,mainly distributed in the comprehensive ICU,tumor hematology,and respiratory departments,and has high resistance rate to penicillins,cephalosporins,and quinolones.2.Compared with the survival group,the death group had a high white blood cell count,a neutrophil count,AST,PCT,and BNP,and a low hemoglobin concentration and a low cholinesterase.3.Cholinesterase is an independent risk factor for hospital-acquired infection caused by multidrug-resistant Klebsiella pneumoniae,and negatively correlated with prognosis.