神经外科ICU患者医院感染特点及危险因素分析

Targeted surveillance risk factors of nosocomial infection in the neurosurgical ICU

目的了解神经外科重症监护病房(NICU)的医院感染情况并探讨其危险因素,为医院感染的预防和控制提供理论依据。方法对2020年1月至2021年12月入住NICU的患者进行医院感染目标性监测,统计医院感染率、器械相关感染发病率、病原菌分布等,利用logistic回归分析筛选医院感染的独立危险因素。结果123例患者中有30例发生医院感染,感染率为24.39%;呼吸机相关肺炎、导尿管相关尿路感染、血管导管相关感染的发病率分别为15.74%、6.74%、1.76%;医院感染的病原菌以革兰氏阴性菌为主;GCS(3~4分)(OR=24.016,P=0.001)、气管切开(OR=5.438,P=0.041)和使用呼吸机>7 d(OR=8.549,P=0.023)是NICU患者发生医院感染的独立危险因素。结论NICU医院感染率较高,尤其是呼吸机相关肺炎及导尿管相关尿路感染,应采取针对性的预防控制措施。

Objective To explore risk factors for nosocomial infections in neurosurgical intensive care units(NICU)to provide a theoretical basis for the prevention and control of nosocomial infections.Methods Patients admitted to NICU from January 2020 to December 2021 were monitored for nosocomial infection.Nosocomial infection rate,incidence of device-related infection,and distribution of pathogenic bacteria were counted.Independent risk factors for nosocomial infection were screened by logistic regression analysis.Results Among 123 patients,30 patients developed nosocomial infection(24.39%).The incidence of ventilator-associated pneumonia,catheter-associated urinary tract infection and vascular catheter-related infection were 15.74%,6.74%and 1.76%,respectively.The pathogenic bacteria of nosocomial infection were mainly Gram-negative bacteria.GCS score(3-4 points)(OR=24.016,P=0.001),tracheotomy(OR=5.438,P=0.041),ventilator use>7 days(OR=8.549,P=0.023)were independent risk factors for nosocomial infection in NICU patients.Conclusion The nosocomial infection rate of NICU in our hospital is high,especially ventilator-associated pneumonia and catheter-related urinary tract infection.Therefore,targeted prevention and control measures should be taken to reduce the incidence of nosocomial infection.