ObjectiveTo explore the prognostic risk factors for patients with gram positive coccus bloodstream infections.
MethodsBy 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.
ResultsThe 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).
ConclusionsThe 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.
