缺血性脑卒中合并医院感染相关因素及感染部位、病原菌特点分析

Analysis on Related Factors, Infection Sites and Pathogen Features of Ischemic Stroke Combined with Nosocomial Infection

目的:分析缺血性脑卒中合并医院感染的相关因素、感染部位及病原菌特点。方法:回顾性分析2010年8月-2016年8月我院收治的192例缺血性脑卒中合并医院感染的临床资料,记录医院感染发生的相关因素、感染部位及病原菌分布情况。结果:缺血性脑卒中合并医院感染主要以呼吸道感染为主,占60.42%(116/192),其余为泌尿道感染、皮肤软组织感染、口腔感染、其他部位感染。192例送检标本分离出290株病原菌,以痰液分离菌株最多,占62.07%(180/290),其余为尿液、血液、穿刺液、脓液、分泌物及其他标本;革兰阴性杆菌感染199株,革兰阳性球菌感染64株,真菌感染27株。多因素logistic回归分析显示,意识障碍、糖尿病史、机械通气、多脏器衰竭为缺血性脑卒中合并医院感染发生的独立危险因素(P<0.05)。结论:缺血性脑卒中合并医院感染以呼吸道感染为主,病原菌以革兰阴性杆菌多见,且意识障碍、糖尿病史、机械通气、多脏器衰竭为缺血性脑卒中合并医院感染发生的独立危险因素,临床应高度重视。

Objective To analyze the related factors, infection sites and pathogen features of ischemic stroke combined with nosocomial infection. Methods The clinical data of 192 cases of ischemic stroke combined with nosocomial infection admitted to our hospital from August 2010 to August 2016 were retrospectively analyzed. The related factors, infection sites and pathogen distribution of nosocomial infection were recorded. Results Ischemic stroke combined with nosocomial infection is mainly characterized by respiratory infection, accounting for 60.42%(116/192), followed by urinary tract infection, skin and soft tissue infection, oral infection, and infections of other sites. A total of 290 pathogens were isolated from 192 specimens. The number of strains isolated from sputum specimens was the highest, accounting for 62.07%(180/290), followed by urine, blood, puncture drainage, pus, and secretion and other specimens. There were 199 strains with infection of Gram-negative bacilli, 64 strains with infection of Gram-positive cocci, and 27 strains of fungal infection. Multivariate logistic regression analysis showed that disturbance of consciousness, history of diabetes, mechanical ventilation, and multiple organ failure were independent risk factors for ischemic stroke combined with nosocomial infection ( P <0.05). Conclusion Ischemic stroke combined with nosocomial infection mainly involves respiratory infection, and Gram-negative bacilli are more common in pathogenic bacteria. In addition, disturbance of consciousness, history of diabetes, mechanical ventilation, and multiple organ failure are independent risk factors for ischemic stroke combined with nosocomial infection, which should arouse great attention of clinicians.