脑卒中患者应激性高血糖与导尿管相关性尿路感染的相关性

Relationship between Stress Hyperglycemia and Catheter-related Urinary Tract Infection in Stroke Patients

目的验证导尿管相关性尿路感染(CAUTI)与脑卒中患者留置导尿管期间应激性高血糖的相关性。方法采用医院感染监测系统追踪某医院脑卒中患者中CAUTI发生情况。研究队列为2016年1月至2020年3月所有脑卒中接受保留导尿治疗的患者。按巢式病例-对照设计,用多变量Logistic回归分析方法,比较病例及对照中脑卒中患者在留置导尿期间发生应激性高血糖的情况。结果共有322例CAUTI及644例非CAUTI患者进入研究。病例组住院时间为(20.68±3.73)d,对照组住院时间为(13.00±4.01)d,病例组较对照组住院时间明显延长(t=29.473,P<0.001)。脑卒中患者中留置导尿管期间应激性高血糖相对于非应激性高血糖患者CAUTI发生风险更大(OR=2.020,95%CI=1.447~2.821,P=0.000);CAUTI千日发生率更高(P<0.001)。结论脑卒中患者中留置导尿管期间应激性高血糖可使CAUTI发生风险显著增加。

Objective To verify the relationship between catheter-related urinary tract infection(CAUTI)and stress hyperglycemia during catheter retention in stroke patients.Methods We used nosocomial infection monitoring system to track the status of CAUTI in stroke patients in a hospital.The study cohort was all the patients who received retention catheterization from January 2016 to March 2020.According to the nested case-control design,multivariate logistic regression analysis was performed to explore the relationship between stress hyperglycemia and CAUTI in stroke patients with indwelling catheter.Results A total of 322 cases of CAUTI and 644 cases of non-CAUTI were enrolled in this study.The length of stay in the case group was(20.68±3.73)d,significantly longer than that[(13.00±4.01)d]in the control group(t=29.473,P<0.001).Compared with non-stress hyperglycemia,stress hyperglycemia posed a higher risk of CAUTI in the stroke patients with indwelling catheter(OR=2.020,95%CI=1.447-2.821,P=0.000)and led to the higher incidence of CAUTI in one thousand days(P<0.001).Conclusion Stress hyperglycemia in the stroke patients with indwelling catheter can significantly increase the risk of CAUTI.