Clinical Analysis of Association Between Different Bacterial Infections and Prognosis in Patients with Sepsis

LI Jun-yao; LI Li-jun; LIU Li-bo

doi:10.13730/j.issn.1009-2595.2017.05.006

Abstract：Objective To analyze the effects of different bacterial infection on the severity and prognosis of patients with sepsis.Methods A total of 123 sepsis patients with positive blood culture from March 2014 to April 2016 were collected in intensive care unit (ICU) and divided into Gram-negative bacteria (G-) group (n=67) and Gram-positive bacteria (G+) group (n=56) by different types of bacterial infections, moreover choice 50 non-infected patients as control group.The inflammatory markers such as procalcitonin (PCT),C-reactive protein (CRP), interleukin 6(IL-6), white blood cell (WBC),and the coagulation function indexes including platelet count (PLT),prothrombin time (PT),activated partial thromboplastin time (APTT) and fibrinogen(FIB),were all detected before treatment.The acute physiology and chronic health evaluation II (APACHEⅡ) scores and mortality in emergency department sepsis (MEDS) scores were recorded, and mortality rate was observed.Results The percentage of patients with early,severe sepsis and septic shock were 50.75%,23.88%,25.37% in G-group,and 58.93%,30.36%,10.71% in G+ group,respectively.The number of septic shock patients in G-group were significantly more than those in G+ group (P<0.05).The main infective bacteria,in turn,were escherichia coli (28.35%),klebsiella pneumoniae (25.37%),pseudomonas aeruginosa (11.94%) in G-group,and staphylococcus aureus (35.71%),streptococcus pneumonia (19.64%),staphylococcus epidermidis (14.28%) in G+ group.Compared with G+ group,PCT,CRP and IL-6 contents in the G-group were significantly higher (P<0.05),PLT and FIB contents were remarkably lower (P<0.05),meanwhile,time of PT and APTT were obviously delayed (P<0.05),WBC was no significantly difference (P>0.05).The APACHEⅡand MEDS scores in G-group were significantly higher than those in G+ group (P<0.05),at the same time,the mortality rate of G-group was more than that in G+ group (28.35%,12.50%,P<0.05).Conclusion The sepsis patients in G-group are more severe than those in G+ group,and the mortality is also higher,owing to higher inflammatory factors and coagulation disorders in G-group.