脑卒中患者尿路感染细菌学特征及危险因素分析

Bacteriological characteristics and risk factors for urinary tract infections in stroke patients

目的探讨脑卒中患者并发尿路感染的细菌学特征及危险因素。方法收集2008年1月-2010年10月神经内外科住院的脑卒中2954例患者临床资料,对其进行统计分析,并与同期心内科及相关科室住院冠心病并发尿路感染患者进行比较。结果 108例脑卒中患者发生尿路感染3.7%,尿培养共获得84株病原菌,革兰阴性杆菌57株占67.9%,革兰阳性球菌18株占21.4%,真菌9株占10.7%;前4位病原菌依次为:大肠埃希菌、肺炎克雷伯菌、奇异变形菌、粪肠球菌;其中患者长期卧床、意识障碍、留置导尿管是脑卒中患者尿路感染的危险因素。结论脑卒中患者尿路感染受多方面危险因素影响,因此,可以采取相应措施防止脑卒中患者尿路感染的发生。

OBJECTIVE To study the bacteriological characteristics and risk factors for urinary tract infections in stroke patients.METHODS A retrospective study was carried out to investigate the clinical data of 2954 stroke patients in department of neurology and neurosurgery from Jan 2008 to Oct 2010.Then the clinical risk factors for urinary tract infections in stroke patients were compared with those with the coronary heart disease complicated with urinary tract infections in department of cardiology and related departments during the same period.RESULTS Totally 108（3.7%） stroke patients were with urinary tract infections;a total of 84 strains of pathogenic bacteria were cultured from urine,including 57 strains of gram-negtive bacilli（67.9%）,18 strains of gram-positive coccobacteria（21.4%）,and 9 strains of fungi（10.7%）;the top 4 pathogens isolated were in order as follows：Escherichia coli,Klebsiella pneumonia,Proteus mirabilis,and Enterococcus faecalis;long bed rest,the disturbance of consciousness,and Indwelling urinary are special risk factors of stroke patients with urinary tract infection.As compared with coronary heart disease patients with urinary tract infection,there were statistically significant differences in percentage of Lying in bed,conscious disturbance,and indwelling urinary catheter were the risk factors for urinary tract infections in stoke patients.CONCLUSION The urinary tract infections in stoke patients are subject to various risk factors,therefore,we can take appropriate measures to prevent the stroke patients away from urinary tract infections.