The Retrospective Investigation And Analysis Of Catheter-related Bloodstream Infection In Intensive Care Unit

Objective:1.To investigate the incidence and the distribution of catheter-relatedbloodstream infection(CRBSI) in the intensive care unit(ICU) at our hospital.2.Toinvestigate the species distribution and antibiotic resistance among the CRBSI in ICU.3.According to the bacteria antimicrobial susceptibility test results, to provide evidencefor the guidance of clinical rational administration.4.To analyze the risk factors forCRBSI.Methods: The discharged patients medical record from ICU were retrospectivelyanalyzed during January2009~December2011, by referring to medieal record andnosocomial infection register to investigate the prevalence of CRBSI. The investigatedcontent mainly include ID, medical record number, name, gender, age, the date ofadmission and discharge, primary diagnoses and the outcomes of thePatients.Meanwhile, events including blood transfusion, mechanical ventilation, lactin,polymicrobial BSI, APACHEⅡscore, as well as Gastrointestinal hemorrhage ofhospitalization were also reviewed. A retrospective analysis was performed to reviewthe microbiological and susceptibility test data of all CRBSI in ICU from January2009to December2011. The patterns of antibiotic resistance among the top seven bacteriaswere compared．Logistic regression method was introduced to investigate the potentialprognostic risk factors.Results:1. The catheter-related bloodstream infection incidence rates:Among the987ICUpatients,67got the catheter-related bloodstream infection(6.8%). Age distribution: Theages of the patients were between21to96(69.1±14.9).Sex distribution:47got infection among the613male(7.7%);20got infection among the374female(5.4%). The motalityof the patients is44.8%(30/67).2.67cases of CRBSI were detected with81strains, including40Gram-positive(G+) bacteria(49.4%),38Gram-negative(G一) bacteria (46.9%), and3fungi(3.7%)．Themain pathogens causing CRBSI were coagulase negative staphylococci(27,33.3%),Acinetobacter baumannii(12,14.8%), Klebsiella pneumoniae (9,11.1%), S.aureus (8,9.9%), Pseudomonas aeruginosa(7,8.6%), Escherichia coli (6,7.4%), suggesting thatStaphylococcus epidermidis was predominant pathogenic G+bacteria, andAcinetobacter baumannii was predominant G—bacteria．The antibiotic resistance testsdemonstrated that isolated G—bacillus was highly sensitive to carbopenem, whilevancomycin-resistant G+bacteria were not found．3. With multiple logistic regressions, age≥65(OR=5.790,95%CI=1.196~28.020,P=0.029), higher APACHEⅡ score (OR=1.150,95%CI=1.048~1.263, P=0.003)andpolymicrobial BSI (OR=17.756,95%CI=1.870~168.638, P=0.012)were independentpredictors of worse outcome.Conclusions：Within the latest3years, the prevalence of pathogens infection areStaphylococcus epidermidis and Acinetobacter baumannii in CRBSI inICU．Acinetobacter baumannii exhbited high drug resistance to all antibiotic. Advancedage, disease severity and polymicrobial BSI should be regarded as a significantindependent risk factor of the CRBSI patients in ICU for mortality.