神经外科住院患者下呼吸道医院感染病原菌及影响因素分析

An analysis of pathogen and influencing factors of nosocomial infection of lower respiratory tract in neurosurgical inpatients

目的分析神经外科住院患者下呼吸道医院感染的病原菌及影响因素。方法回顾性分析1 021例神经外科住院患者的临床资料,其中下呼吸道医院感染患者43例,分析下呼吸道医院感染的病原菌及其影响因素。结果 43例下呼吸道医院内感染患者中,共检出病原菌31株,包括肺炎克雷伯菌9株、金黄色葡萄球菌6株、铜绿假单胞菌5株、阴沟肠杆菌3株、鲍氏不动杆菌2株、大肠埃希菌2株和其他4株。Logistic回归分析发现,昏迷、呕吐、留置胃管与鼻饲、使用呼吸机、感染前使用激素和感染前使用镇静剂是神经外科住院患者发生下呼吸道医院感染的危险因素(P<0.01)。结论神经外科住院患者下呼吸道医院感染的病原菌主要是革兰阴性杆菌,昏迷、呕吐、留置胃管与鼻饲、使用呼吸机、感染前使用激素和感染前使用镇静剂是其主要危险因素。

Objective To analyze the pathogen and influencing factors of nosocomial infection of lower respiratory tract in neurosurgical inpatients.Methods The data of 1 021 neurosurgical inpatients were retrospectively analyzed,of whom 43 cases with nosocomial infection of lower respiratory tract.The pathogen and influencing factors of nosocomial infection of lower respiratory tract were analyzed.Results Of 43 cases,31 strains of pathogenic bacteria were detected,which were9 strains of Klebsiella pneumoniae,6 strains of Staphylococcus aureus,5 strains of Pseudomonas aeruginosa,3 stains of Enterobacter cloacae,2 strains of Acinetobacter baumannii,2 strains of E.coli and 4 strains of others.Coma,vomiting,indwelling stomach tube and nasal feeding,using ventilator,using hormone and sedative before infection were the risk factors for nosocomial infection of lower respiratory tract.Conclusion The main pathogen of nosocomial infection of lower respiratory tract in neurosurgical inpatients was Gram negative bacilli.Coma,vomiting,indwelling stomach tube and nasal feeding,using ventilator,using hormone and sedative before infection are the risk factors for nosocomial infection of lower respiratory tract in neurosurgical inpatients.