神经外科医院感染相关危险因素分析

发布时间：2018-04-18 08:28

本文选题：神经外科 + 医院感染　；参考：《中华医院感染学杂志》2014年04期

【摘要】：目的分析神经外科医院感染患者的病情、流行病学特征及导致感染发生的危险因素,为神经外科控制医院感染提供临床参考依据。方法回顾性分析2012年1月-2013年7月医院神经外科1 732例住院患者临床资料,对医院感染发生率及感染部位、医院感染病原菌分布和药敏试验等进行分析,同时对神经外科医院感染的危险因素进行统计处理,对单因素进行χ2检验,多因素进行logistic回归分析,筛选出导致患者发生医院感染的危险因素。结果 1 732例住院患者中发生医院感染157例,感染率9.1%;感染部位以下呼吸道为主占41.4%;年龄、住院天数、手术类型等是诱发神经外科患者医院感染的危险因素(P0.05),经logistic回归分析,年龄、手术类型、开颅手术为独立危险因素(P0.01);157例患者标本培养中共分离出病原菌172株,其中革兰阴性菌119株占69.2%,革兰阳性菌31株占18.0%,真菌22株占12.8%;鲍氏不动杆菌和大肠埃希菌对氨苄西林耐药率均为100.0%,肺炎克雷伯菌和大肠埃希菌对环丙沙星的耐药率均为100.0%,鲍氏不动杆菌和大肠埃希菌对亚胺培南的耐药率为0。结论神经外科患者易发生医院感染,临床中应重点关注年龄、住院天数、手术类型、留置尿管、开颅手术等神经外科医院感染发生的危险因素,分析患者病原菌,根据药敏试验结果针对性的合理应用抗菌药物,努力降低神经外科医院感染发生率。
[Abstract]:Objective to analyze the condition, epidemiological characteristics and risk factors of nosocomial infection in neurosurgery patients, so as to provide clinical reference for neurosurgery to control nosocomial infection.Methods the clinical data of 1,732 inpatients with neurosurgery from January 2012 to July 2013 were retrospectively analyzed. The incidence and location of nosocomial infection, the distribution of nosocomial infection pathogens and drug sensitivity test were analyzed.At the same time, the risk factors of nosocomial infection in neurosurgery were statistically treated, the single factor was tested by 蠂 2 test, and the multiple factors were analyzed by logistic regression analysis, and the risk factors of nosocomial infection were screened out.Results among the 1 732 inpatients, 157 cases had nosocomial infection, the infection rate was 9.1%, the respiratory tract below the infected site accounted for 41.4%, age, length of stay in hospital, type of operation were the risk factors of nosocomial infection in neurosurgery patients, and the risk factors were analyzed by logistic regression analysis.Age, type of operation, craniotomy as an independent risk factor, 172 strains of pathogenic bacteria were isolated from 157 patients.Among them, 119 strains of Gram-negative bacteria accounted for 69.2%, 31 strains of Gram-positive bacteria accounted for 18.0 and 22 strains of fungi accounted for 12.8.The resistance rates of Acinetobacter baumannii and Escherichia coli to ampicillin were both 100.0.The resistant rates of Klebsiella pneumoniae and Escherichia coli to ciprofloxacin were 100.0.The resistance rate of Acinetobacter baumannii and Escherichia coli to imipenem was 0. 0.Conclusion Nosocomial infection is easy to occur in neurosurgical patients. The risk factors of nosocomial infection in neurosurgery such as age, length of stay in hospital, type of operation, indwelling urethral catheter and craniotomy should be paid more attention to, and the pathogenic bacteria of the patients should be analyzed.According to the results of drug sensitivity test, the rational use of antimicrobial agents to reduce the incidence of nosocomial infection in neurosurgery.
【作者单位】：武警后勤学院附属医院脑科医院;天津中医药大学;
【基金】：天津市自然科学基金资助项目(12JCZDJC24100)
【分类号】：R181.32

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