The Rationality Analysis Of Blood Stream Infection Treatment Drugs And Their Effect On Patients

Objective: To analyze the clinical and etiological characteristics of pathogenic bacteria in patients with bloodstream infection,and to evaluate the rationality of drugs used in the stage of empirical treatment,so as to provide valuable reference for clinical empirical use of drugs.Methods: 1.Clinical characteristics and pathogenic analysis:The positive pathogenic bacteria and their information are collected from January to December 2017 in the First Affiliated Hospital of China Medical University.WHONET 5.6 and SPSS 26.0 are used to analyze the clinical characteristics and drug resistance of blood flow infection pathogens.2.The rationality assessment:The clinical data of patients with bloodstream infection in the inpatients of our hospital from January to December 2017 are retrospectively analyzed.SPSS 26.0 is used for statistical analysis,and the rationality of their empirical medication is evaluated.Results: 1.Clinical characteristics and pathogenic analysis : There are 405 patients,including 260 nosocomial infections and 145 community infections,with a total fatality rate of 13.09%.The most common Department of bloodstream infection is still the Department of critical medicine.The most common sites of secondary bloodstream infection are lung,abdominal cavity and urinary system.A total of 480 strains of pathogenic bacteria are detected,including 414 strains of bacteria,58 strains of fungi and 8 other strains.The top five bacteria in clinical distribution are Escherichia coli(ECO),Klebsiella pneumoniae(KPN),Staphylococcus aureus(SAU),Enterococcus faecium(EFM)and Acinetobacter baumannii(ABA).Among the bacteria,195 strains of multidrugresistant(MDR)bacteria are found,of which 132 strains are nosocomial infection.Among the non-fermentative bacteria,23 strains of ABA,7 strains of Pseudomonas aeruginosa(PAE),7 strains of Pseudomonas putida and 1 strain of ajo Acinetobacter johnsonii,1 strain of Acinetobacter junii and 1 strain of Acinetobacter lwoffii are isolated resistant to imipenem.2.The rationality assessment:There are 394 patients,and the top five pathogens are ECO(14.6%),KPN(11.8%),SAU(10.2%),EFM(6.9%)and ABA(6.7%).The top five departments with bloodstream infections are intensive care unit(15.2%),gastrointestinal oncology surgery(7.9%),pancreaticobiliary surgery(7.6%),infection department(6.3%)and hematology department(6.1%).The most common site of secondary infection is the lung.Imipenem / cilastatin sodium for injection,meropenem for injection and cefoperazone sodium / sulbactam sodium for injection are commonly used in empirical medicine.the unreasonable rate of empirical drug use is 30.5%,mainly due to inappropriate drug selection.Conclusion: 1.The pathogens of bloodstream infection in our hospital have multiple-drug resistance,and most of them are nosocomial infections.The drug tolerance of common pathogenic bacteria such as ECO,KPN,ABA and PAE are serious,so we should strengthen the drug control of these pathogenic bacteria in the hospital.2.The common pathogens of empirical stage in our hospital are ECO,KPN and SAU.The reasonable rate of empirical drugs is 69.5%.Imipenem / cilastatin sodium for injection is the most commonly used drug.