Analysis of prognostic risk factors of bloodstream infections in Beijing communities: A retrospective study from 2015 to 2019

Abstract

Objective: This study intends to investigate the prognostic risk factors of bloodstream infection in Beijing. Methods: This study is a clinical retrospective study. Four hundred forty-six patients with community-onset bloodstream infections (COBSI), admitted to the emergency department and inpatient department of Beijing Jishuitan Hospital from January 1, 2015, to December 31, 2019, were selected as the main research objects. According to whether the patient survives for 100 days or not, 363 cases were in the survival group, and 83 cases were in the death group. By analyzing the clinical data of the two groups of patients, the epidemiology, clinical characteristics, bacterial resistance, and risk factors affecting the prognosis of the patients were analyzed. Results: A total of 446 pathogenic bacteria were isolated in this study, including 324 Gram-negative (G-) bacteria (72.6%), 121 Gram-positive (G+) bacteria (27.1%). The results of the study showed that there were significant differences in MDR, initial antibiotic use, solid tumor, CKD, septic shock, acute liver injury, AKI, central venous catheter, urinary catheter, blood replacement therapy, invasive operation, and use of three or more antibiotics between the two groups (p<0.05). The multiple logistic regression analysis showed that solid tumors (OR=3.339, 95% CI: (1.441, 7.734), p=0.005), combined septic shock (OR=20.729, 95% CI: (10.235, 41.982), p<0.001), indwelling catheters (OR=3.556, 95% CI: (1.538, 8.222), p=0.003) and continuous venovenous hemofiltration (CVVH, OR=19.548, 95% CI: (8.724, 35.641), p=0.003) are independent risk factors affecting the prognosis of COBSI patients. Appropriate initial antibiotic therapy is a protective factor affecting the prognosis of COBSI patients. Conclusion: Solid tumors, combined septic shock, indwelling catheters, CVVH are independent risk factors affecting the prognosis of COBSI patients.