Prognotic Risk Factors of Gram Positive Coccus Bloodstream Infection_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

MaLi ¹ , LiLijuan ² ,  LinJiangtao ² , LiuGuoliang ² , ChenXinwang ² , LiGang ³

1. Department of Respiratory Medicine, First People's Hospital of Qujing, Quqing, Yunnan, 655000, China;
2. ;
3. ;

Corresponding author：

LinJiangtao, Email: jiangtao_1@263.net

Keywords：

Gram positive coccus; Bloodstream infections; Prognosis; Risk factors

DOI：

10.7507/1671-6205.2016003

Video：

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Objective To explore the prognostic risk factors for patients with gram positive coccus bloodstream infections. Methods By retrospective analysis, 93 patients with gram positive coccus bloodstream infections were recruited from the China-Japan Friendship Hospital during January 2013 to April 2015.According to the 28-day survival situation, the patients were divided into a survival group and a death group.The clinical data including basic diseases and invasive operation were collected.Logistic regression analysis was used to evaluate the risk factors for predicting prognosis. Results The albumin concentration in the death group was lower than that in the survival group (P < 0.05).The D-Dimer concentration, APACHEⅡscores, the percentage of patients with mechanical ventilation, and the percentage of patients with deep venous cannels in the death group were all higher than those in the survival group (P < 0.05).The percentages with diabetes mellitus, surgery, tumor, renal failure in the patients with enterococcus bloodstream infections were much higher than those patients with other gram positive coccus bloodstream infections (P < 0.05), but were not different with those patients with Staphylococcus aureus bloodstream infection (P > 0.05).The APACHEⅡscore and albumin concentration had statistical significance for predicting the 28-day and 90-day mortality.The area under the receiver operating characteristic (ROC) curve was 0.768 and 0.775.If using APACHEⅡscore > 22.5 as cut off value for predicting death in 28 days, the sensitivity was 70.0%, and the specificity was 81.2%.If Using albumin concentration < 32.5 g/L as a cutoff value for predicting death in 28 days, the sensitivity was 55.3%, and the specificity was 86.7%. The logistic multifactor analysis revealed only the lower albumin concentration was an independent prognostic factor for 28-day mortality of the patients with gram positive coccus bloodstream infections (P < 0.05). Conclusions The patients with diabetes mellitus, surgery, tumor, and renal failure need to be cautious of enterococcus bloodstream infection.The low albumin concentration suggests a poor prognosis in patients with gram positive coccus bloodstream infections.

Citation： MaLi, LiLijuan, LinJiangtao, LiuGuoliang, ChenXinwang, LiGang. Prognotic Risk Factors of Gram Positive Coccus Bloodstream Infection. Chinese Journal of Respiratory and Critical Care Medicine, 2016, 15(1): 7-11. doi: 10.7507/1671-6205.2016003 Copy

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5.	何超, 陈知行, 郭培玲, 等.重症患者血培养病原菌的分布及耐药性分析.中国呼吸与危重监护杂志, 2012, 11:153-156.
6.	汪复, 朱德妹, 胡付品, 等.2009年中国CHINET细菌耐药性监测.中国感染与化疗杂志, 2010, 10:325-334.
7.	魏泽庆, 沈萍, 陈云波, 等.Mohnarin2011年度报告:血流感染细菌构成及耐药性.中华医院感染学杂志, 2012, 22:465-470.
8.	Libert M, Elkholti M, Massaut J, et al.Risk factors for meticilin resistance and outcome of Staphylococcus aureus bloodstream infection in a Belgian university hospital.J Hosp Infect, 2008, 68:17-24.
9.	Vincent JL, Dubois MJ, Navickis RJ, et al.Hypoalbuminemia in acute illness:is there a rationale for intervention? A meta analysis of cohort studies and controlled trials.Ann Surg, 2003, 237:319-334.
10.	Zimmerman JE, Kramer AA, McNair DS, et al.Acute Physiology and Chronic Health Evaluation(APACHE)Ⅳ:hospital mortality assessment for today's critically ill patients.Crit Care Med, 2006, 34:1297-1310.
11.	孟玉兰, 王宁, 黄伟.脓毒症相关病情与预后评分系统的进展.中国呼吸与危重监护杂志, 2015, 14:517-520.
12.	梁微波, 庞晓清, 刘晓青, 等.动态监测血清可溶性髓样细胞触发受体1对脓毒症的诊断及预后评估价值.中国呼吸与危重监护杂志, 2014, 13:53-57.

1. 康焰.脓毒症的现代诊断与治疗.中国呼吸与危重监护杂志, 2009, 8:104-105.
2. Marra AR, Camargo LF, Pignatari AC, et al. Nosocomial bloodstream infections in Brazilian hospitals:analysis of 2563 cases from a prospective nationwide surveillance study.J Clin Microbiol, 2011, 49:1866-1871.
3. vail der Kooi TI, Manniim J, Wille JC, et al.Prevalence of nosocomial infections in The Netherlands.2007-2008:results of the first four national studies.J Hosp Infect, 2010, 75:168-172.
4. 张黎, 刘正印, 徐英春, 等.成人原发血流感染494例临床分析.中华医学杂志, 2012, 13:894-898.
5. 何超, 陈知行, 郭培玲, 等.重症患者血培养病原菌的分布及耐药性分析.中国呼吸与危重监护杂志, 2012, 11:153-156.
6. 汪复, 朱德妹, 胡付品, 等.2009年中国CHINET细菌耐药性监测.中国感染与化疗杂志, 2010, 10:325-334.
7. 魏泽庆, 沈萍, 陈云波, 等.Mohnarin2011年度报告:血流感染细菌构成及耐药性.中华医院感染学杂志, 2012, 22:465-470.
8. Libert M, Elkholti M, Massaut J, et al.Risk factors for meticilin resistance and outcome of Staphylococcus aureus bloodstream infection in a Belgian university hospital.J Hosp Infect, 2008, 68:17-24.
9. Vincent JL, Dubois MJ, Navickis RJ, et al.Hypoalbuminemia in acute illness:is there a rationale for intervention? A meta analysis of cohort studies and controlled trials.Ann Surg, 2003, 237:319-334.
10. Zimmerman JE, Kramer AA, McNair DS, et al.Acute Physiology and Chronic Health Evaluation(APACHE)Ⅳ:hospital mortality assessment for today's critically ill patients.Crit Care Med, 2006, 34:1297-1310.
11. 孟玉兰, 王宁, 黄伟.脓毒症相关病情与预后评分系统的进展.中国呼吸与危重监护杂志, 2015, 14:517-520.
12. 梁微波, 庞晓清, 刘晓青, 等.动态监测血清可溶性髓样细胞触发受体1对脓毒症的诊断及预后评估价值.中国呼吸与危重监护杂志, 2014, 13:53-57.

Chinese Journal of Respiratory and Critical Care Medicine

Prognotic Risk Factors of Gram Positive Coccus Bloodstream Infection

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