Study on the distribution of pathogenic bacteria and influencing factors of chronic critical illness in sepsis patients
Li Ji
Zhang Zhongheng
Ni Hongying
Yang Jie
Yang Suibi
Zhang Jing
Fang Qiao
Abstract：Objective To explore the distribution of pathogenic bacteria and influencing factors of chronic critical illness in sepsis patients.Methods A retrospective analysis was conducted on the clinical data of 292 sepsis patients from December 2023 to September 2025.Based on the clinical trajectory of the patients,they were divided into a chronic critical illness(CCI)group(n=116)and a rapid recovery(RR)group(n=176).The general basic information,blood routine,coagulation routine,C-reactive protein(CRP),procalcitonin(PCT),and related evaluation indicators of the two groups were compared and analyzed.Logistic regression analysis was used to screen for independent factors affecting sepsis prognosis.Results Among the pathogenic bacteria,Klebsiella pneumoniae was the main one(39 strains,accounting for 17.33％),followed by Escherichia coli(34 strains,accounting for 15.11％)and Acinetobacter baumannii(30 strains,accounting for 13.33％).The main site of infection in the patients was pulmonary infection(121 cases,accounting for 42.31％),followed by peritonitis(40 cases,accounting for 13.99％)and urinary tract infection(28 cases,accounting for 9.79％).In univariate analysis,there were significantly statistical differences in age,comorbidities,D-dimer(D-D),CRP,PCT,blood creatinine,blood urine nitrogen,Glasgow coma scale(GCS)score,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,the days of ventilator use,the days of blood purification,and the days of vasoactive drugs use between RR group and CCI group(P＜0.05).In multivariate Logistic regression analysis,age,combined underlying diseases,D-D,PCT,blood creatinine,GCS score,APACHE Ⅱ score,the duration of ventilator use,and the duration of vasoactive drug use were independent prognostic factors for sepsis patients(OR=3.336,7.524,1.366,1.332,1.037,1.213,1.581,1.861,1.037,P＜0.05).A predictive model was constructed based on risk factors:logit(P)=-3.356+1.205 × ≥70 years+2.018 × comorbidities+0.312 × D-D+0.287 × PCT+0.036 × blood creatinine+0.193 × GCS scores+0.458 × APACHE Ⅱ+0.621 × the duration of ventilator use+0.036 × the duration of vasoactive drug use.The area under curve of the prediction model was 0.922(95％CI 0.901-0.963),with the sensitivity of 89.7％,the specificity of 87.4％,Youden's index of 0.771.Conclusions The pathogens of sepsis patients are mainly Klebsiella pneumoniae,Escherichia coli and Acinetobacter baumannii.And age,combined with underlying diseases,D-D,PCT,blood creatinine,GCS score,APACHE Ⅱ score,the duration of ventilator use,and the duration of vasoactive drugs use are independent factors affecting the prognosis of sepsis patients.Intervention and treatment should be strengthened for elderly patients with underlying diseases,especially for abnormal conditions such as blood routine and coagulation routine,and timely and effective treatment measures should be given.
Keywords：SepsisBlood flow infectionPathogenic bacteriaInfluencing factorsPrognosisEffect
Publication Date：2025-11-10
Online Publishing Date：2025-12-09(First online date of this platform, not the publication date of the document)
Pages：6( 976-981 )