Clinical characteristics,microbial distributions and clinical outcome risk factors of 225 patients with posi-tive sterile body fluid culture in intensive care unit at a tertiary hospital
OBJECTIVE To explore the microbiological isolates and clinical risk factors for positive culture in sterile body fluid in patients in intensive care unit(ICU)to provide therapeutic rationales.METHODS From January 1,2020 to December 31,2022,retrospective review was performed for 225 ICU patients with positive sterile body fluid culture at Second Hospital of Shanxi Medical University.The distributions of sterile body fluid microorganisms were analyzed.Propensity score matching(PSM)was utilized for eliminating confounding factors.Univariate and multivariate Logistic regressions were employed for exam-ining the risk factors for mortality.And the regression results were assessed by Hosmer-Lemeshow test and receiver operating characteristic(ROC)curve.RESULTS A total of 297 non-repetitive strains were isolated from enrolled patients,including 131 Gram-positive bacteria(44.11％),137 Gram-negative bacteria(46.13％)and 25 fungi(8.42％).Top five isolates were Esch-erichia coli,Enterococcus faecium,Acinetobacter baumannii,Klebsiella pneumoniae and Staphylococcus haemolyticus.Blood specimen was a major source of isolation(73.06％),followed by ascites(19.2％).After PSM,168 patients were included for risk factor analysis.Multivariate analysis indicated that pre-hospital cardiopulmonary resuscitation,disturbance of consciousness and central venous catheterization were independent risk factors for mortality while drainage tube placement was a protective fac-tor.The discrimination and calibration of regression results were satisfactory.CONCLUSION In ICU patients,the proportion of positive and negative bacteria isolated from sterile body fluids is equivalent.And blood sample remains a major source of isola-tion.The prediction of mortality risk factors in sterile body fluid culture positive patients through Logistic multiple regression pro-vides theoretical rationales for formulating clinical treatment protocols and personalized interventions.
clinical characteristicssterile body fluidsmicrobial distributionclinical outcomeslogistic regressionrisk fac-tor analysis
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