Clinical Analysis Of Bacteremia In Critically Ⅲ Patients With Single Center Experience In Treatment Of Patients With Severe Influenza With Viral Pneumonia In ICU

Objective:To review and analyze the positive blood microbial specimens in the two wards of Intensive Care Unit,Qilu Hospital from January 2014 to December 2015.Method:Age,sex,underlying disease,pathogenic microbial type,intravascular invasive operation,artificial airway,mechanical ventilation,nutritional support route,ICU LOS,total length of stay and prognosis of patients with bacteremia were observed and recordedResults:A total of 219 patients were enrolled in this study.There were 130 cases(59.4%)in ICU ward I and 89 cases(40.6%)in ICU ward II.There were 160 males(73.1%)and 59 females(26.9)with mean age 59.1 ± 18.6 years old.There were 46 cases(21.0%)of abdominal surgical lesions,46 cases(21.0%)of abdominal lesions,34 cases(15.6%)of neuromuscular lesions,30 cases(13.7%)of severe burns and complex skin and soft tissue infections,COPD and severe pneumonia 24(10.9%),orthopedic surgery in 13 cases(5.9%),chronic renal failure in 11 cases(5.0%),the other 15 cases(6.9%).121 patients(55.3%)had blood culture as Gram-positive cocci,80 patients had Gram-negative bacilli(36.5%),and 18 patients(8.2%)were Candida.Among the top five bacteria were Staphylococcus epidermidis 31 cases(14.2%),Acinetobacter baumannii 27 cases(12.3%,23 cases of human staphylococcus subspecies(10.5%),20 cases of enterococcus faecalis(9.1%),Klebsiella pneumoniae in 16 cases(7.3%).Of the 219 patients with severe blood culture,119(54.3%)had only one blood culture positive,57(26.0%)were positive for blood culture,23 patients(10.5%)had positive blood culture,15 patients(6.8%)were positive for blood culture,1 patient(0.5%)had blood culture positive,and 4 patients(1.8%)had blood culture positive.There were 90 cases(41.1%)of subclavian vein catheter,51 cases(23.3%)of femoral vein catheter,16 cases(7.3%)of internal jugular vein and 14 cases(6.4%)of PICC.Among them,83 cases(37.9%)patients with arterial catheterization,tracheal intubation and tracheotomy in 197 cases(90.0%),mechanical ventilation in 178 cases(81.3).(P<0.05),49(22.4)were treated with total parenteral nutrition(TPN)and 158(72.1%)were treated with enteral nutrition.126 cases(57.5%)were discharged and 67 cases(30.6%)died and 26 cases(11.9%)were discharged.ICU LOS 26.5 ± 23.3 days,total length of stay 36.1 ± 31.2 days.Conclusion:Blood culture specimen collection was not standardized Gram-positive cocci positive rate of one of the main factors.Age and duration of total hospital stay were bloody patients with poor prognostic risk factors.Objective:To explore the experience of severe influenza A viral pneumonia treatment.Methods:The clinical data and treatment of 6 cases of severe influenza with virus RNA-positive pneumonia were analyzed.Results:3 cases of new HIN1 influenza,3 cases did not do further nucleic acid subtype identification,patients were treated with oseltamivir.3 patients with invasive pulmonary aspergillosis,4 patients received invasive mechanical ventilation,2 cases of pneumothorax.3 patients received continuous hemofiltration for acute renal injury,4 with ventilator-associated pneumonia in 5 patients with mechanical ventilation,and 5 patients died.Conclusion:Suffering from severe underlying disease,the use of glucocorticoids,deep sedation,secondary pulmonary infection of influenza A virus causes severe pneumonia and high mortality.