Analysis of influencing factors of Carbapenem-resistant Gram-negative bacilli in emergency patients with bloodstream infection
Objective To explore the influencing factors of carbapenem-resistant gram-negative bacilli(CR GNB)bloodstream infection in emergency patients with bloodstream infection.Methods A total of 228 patients with Gram-negative bacteria bloodstream infection in Beijing Jishuitan Hospital,Capital Medical University from 2015 to 2019 were selected,and were divided into CR GNB group(60 cases)and Non-CR GNB group(168 cases)according to the blood culture results.The ratio of propensity score matching(PSM)was 1:2,and the influencing factors of CR GNB blood flow infection in emergency patients were analyzed by conditional logistic regression.Results Among the 228 patients,there were 125 males and 103 females,aged from 17 to 99 years,with a median age of 77 years,and 59 pairs were successfully matched by PSM.A total of 228 GNB patients were included,including 60 cases in the CR GNB group and 168 cases in the non-CR GNB group.Conditional logistic regression analysis showed that mechanical ventilation within 30 days(OR=4.759,95%CI:1.184-19.127,P=0.028)and carbapenem antibiotics(OR=5.706,95%CI:1.974-16.493,P=0.001),the longer the treatment time before treatment(OR=1.050,95%CI:1.010-1.092,P=0.019),the higher the risk of CR GNB bloodstream infection.Conclusions Mechanical ventilation within 30 days,treated by carbapenem antibiotics within 30 days,and the longer treatment time before treatment are independent risk factors for CR GNB bloodstream infection in emergency patients.The wrong choice of antibiotics should be reduced,and antibiotics should be used more carefully,reasonably and individually in emergency diagnosis and treatment to improve the prognosis..
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