Study On Pathogenic Bacteria Characteristics Of Bloodstream Infection In Tianjin Tanggu District

Background:Bloodstream infection(BSI)is a complex and serious systemic infectious disease,which refers to the transient,intermittent or persistent presence of pathogenic microorganisms in human circulation.It includes septicemia,sepsis,bacteremia and catheter-related BSI,now tend to replace these traditional concepts with"bloodstream infections."BSI is insidious and rapidly.Failure to diagnose and treat it timely can lead to shock,organ failure or death.Blood culture is the gold standard for BSI.It takes a long time to detect pathogenic bacteria and is easy to delay the diagnosis and treatment of patients.Now there are few studies on the main pathogenic bacteria,susceptible population and drug sensitivity in Tanggu area.Objective:By analyzing the pathogenic bacteria of the patients with BSI at the Fifth Central Hospital of Tianjin and Tianjin Port Hospital in recent years,it provides important basis for timely diagnosis and treatment of BSI in Tanggu area.The time to positive(TTP)in BSI was studied,and the value of common inflammatory markers in diagnosing BSI was discussed.It is expected to provide a more convenient,practical and economical method for clinicians to diagnose BSI.Methods:1.Taking the patients with BSI at the Fifth Central Hospital of Tianjin and Tianjin Port Hospital in Tanggu district as the research object,the pathogenic bacteria type,patient age,clinical source and drug sensitivity of the main pathogenic bacteria were analyzed.2.TTP of blood culture bottle of patients with BSI in the Fifth Central Hospital of Tianjin was prospectively recorded,and the TTP in adult patients group and infant patients group was analyzed respectively.3.Adult patients with BSI were selected as the BSI group,and they were divided into Escherichia coli group,Staphylococcus aureus group,and Candida parapsilosis group.The control group was selectedforhealthcontrols.HypersensitiveC-reactiveprotein(Hs-CRP),procalcitonin(PCT),fungalβ(1,3)-D glucan(G test)and blood routine tests were performed on all subjects,and the neutrophil/lymphocyte ratio(NLR)was calculated,Quality control was conducted on the test day and qualified.The differences in the results of different experimental groups were analyzed,and the diagnostic value of each inflammatory index to different kinds of BSI was discussed.The data was analyzed by whonet 5.6 and SPSS 21.0.Results:1.In this region,the majority of patients with BSI are aged over 41 years old,followed by infants under 3 years old,and the composition ratio of different age groups was significantly different(X~2=1001.81,P<0.05).Gram-negative bacteria(mainly including Escherichia coli and Klebsiella pneumoniae)dominated the infection,followed by gram-positive bacteria(mainly including Staphylococcus aureus and Staphylococcus epidermidis).The proportion of gram-positive bacteria and gram-positive bacteria was similar in pediatric patients,while gram-negative bacilli was more common in adult patients,and yeast infection was mainly seen in elderly patients.No pandrug resistant strains were found.2.In the adult group and the infant group,the bacteria with the shortest TTP were all Enterobacteriaceae(Escherichia coli and Enterobacteria,respectively),and the bacteria with the longest TTP were all candida parapsilosis.3.All inflammatory indicators in the BSI group were significantly higher than those in the control group(P<0.05).The G test level in the Candida parapsilosis group was significantly higher than that in other groups(P<0.05).The NLR has high sensitivity and specificity in the diagnosis of BSI of different types of pathogenic bacteria.The comprehensive diagnostic value of NLR for BSI was higher than that of WBC,MEUT,Hs-CRP,PCT and G test.Conclusion:BSI in tanggu district hospital is characterized by people with low immunity,mainly aged over 41 years old and infants under 3 years old.The main pathogenic bacteria were escherichia coli,klebsiella pneumoniae and staphylococcus aureus.The TTP of blood culture was used to preliminarily distinguish the pathogenic bacteria type of BSI.The NLR was used to diagnose BSI.