Clinical analysis of central venous catheter-related infections in patients in the emergency ICU

BACKGROUND:Catheter-related infection(CRI)of the central vein is a common cause of nosocomial infection.This study was undertaken to investigate the pathogen culturing and risk factors of CRI in emergency intensive care unit(EICU)in order to provide the beneficial reference.METHODS:From January 2008 to December 2010,a total of 1 363 patients were subjected to catheterization.In these patients,the peak CRI rate of the patients was determined by bacterial cultivation and blood bacterial cultivation.RESULTS:CRI happened in 147 of the 1 363 patients using the central venous catheter.The peak rate of CRI was 10.79%,with an incidence of 3.05 episodes per 1 000 catheter days.Of the147 patients,46.94%had gram-negative bacilli,40.14%had gram-positive cocci,and 12.92%had fungi.Unconditional logistic regression analysis suggests that multiple catheterization,femoral vein catheterization,the application of multicavity catheter,and the duration of catheterization were the independent risk factors for CRI.CONCLUSION:The risk factors for catheter-related infections should be controlled to prevent the occurrence of nosocomial infection.

Knowledge of“Guidelines for the prevention of intravascular catheter-related infections(2011)”:A survey of intensive care unit nursing staffs in China

Aims and objectives:To evaluate intensive care unit(ICU)nurses'knowledge of the updated guidelines for the prevention of intravascular catheter-related infections;to identify the factors that affect the nurses'knowledge and to explore the barriers to adherence to evidence-based guidelines in clinical practice in China.Methods:Cross-sectional surveys were carried out in Chinese ICUs from January 2013 to March 2014.The nurses'demographic information,knowledge of the guidelines,and barriers to adherence were assessed by a validated questionnaire and then analyzed statistically.Results:The questionnaires were completed by 455 ICU nurses from 4 provinces of China.The mean score was 8.17 of 20,and higher scores were significantly associated with province,years of experience,and years of ICU experience.Forty-nine(10.7%)nurses had not heard of the guidelines,whereas 231(50.7%)nurses heard of the guidelines but did not receive training for them.Trained nurses'scores were higher than untrained nurses'scores.The three main barriers to compliance with the guidelines were an unfamiliarity with them,an excessive workload due to a shortage of nurses,and a lack of training.Conclusions:ICU nurses'knowledge of the updated guidelines is quite low,which could be a potential risk factor for patient safety.Multidisciplinary interventions and continuous.

Analysis of the relationship between deep venous catheter-related infection and post-operative complications in patients receiving minimally invasive esophagectomy

Objective The aim of the study was to evaluate catheter-related infection rate(CRIR)for patients receiving minimally invasive esophagectomy(MIE),to identify the optimal catheterization approach and relationship between CRIR and post-operative complications.Methods In total,168 patients with esophageal carcinoma and undergoing MIE combined with preoperative deep venous catheterization(DVC)were analyzed in our institution(Qingdao Municipal Hospital,China),from 2014 to 2018.After completing DVC,catheter-tips together with intraductal venous blood samples were sent to the microbiology lab for bacterial strain culture.CRIR was statistically evaluated for the following clinical variables:gender,age,smoking status,drinking status,past history,tumor location,histologic grade,pathological T,N,and M category,anastomotic location,anastomotic leakage,anastomotic stricture,chylothorax,pneumonia,recurrent laryngeal nerve(RLN)injury,reflux esophagitis,catheterization site,and catheter-locking days.Results Among the 144 patients recruited in our study,105 catheters were inserted into the jugular vein and 39 catheters into the subclavian vein.The median age of these patients was 63 years(range:42–79 years),and the median catheter-locking period was seven days(range:4–21 days).Four catheters were identified with three types of strain colonizations,including Staphylococcus epidermidis,Staphylococcus aureus and Blastomyces albicans.Statistical data showed that patients diagnosed with catheter-related infection were likely to incur anastomotic leakage(66.67%,P<0.001)and pneumonia(27.27%,P<0.001);features such as tumors located in the upper esophagus(13.6%,P=0.003),and over seven catheterlocking days(10.00%,P<0.001)were attributed to a high CRIR.Conclusion Although both jugular and subclavian veins can be catheterized for patients with MIE,DVC is associated with more than seven catheter-locking days and upper esophagectomy,due to high CRIR.Furthermore,catheter-related infection is related to anastomotic leakage and pneumonia.

Catheter-related infections caused by Mycobacterium abscessus in a patient with motor neurone disease:A case report

BACKGROUND Mycobacterium abscessus(M.abscessus)is a rapidly growing mycobacterium and ubiquitous in the environment,which infrequently causes disease in humans.However,it can cause cutaneous or respiratory infections among immunocompromised hosts.Due to the resistance to most antibiotics,the pathogen is formidable and difficult-to-treat.CASE SUMMARY Here,we present a case of catheter-related M.abscessus infections in a patient with motor neurone disease.Catheter and peripheral blood cultures of the patient showed positive results during Gram staining and acid-fast staining.The alarm time of catheter blood culture was 10.6 h earlier than that of peripheral blood.After removal of the peripherally inserted central catheter,secretion and catheter blood culture were positive.M.abscessus was identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry and 16S rDNA sequencing.CONCLUSION For catheter-related M.abscessus infection,rapid diagnosis and timely and adequate antimicrobial therapy are crucial.

Prevention of central venous catheter-related infection in ICU with cluster nursing intervention: a meta-analysis

Objective:To systematically evaluate the clinical effects of cluster nursing intervention in preventing central venous catheter-related infection in intensive care unit.Methods:A randomized controlled study was searched from China National Knowledge Internet(CNKI),Wanfang,Chinese Scientific Journals Database(VIP),Chinese Biomedical Literature Service System(SinoMed),PubMed,Embase and Cochrane library databases from the establishment to May 1,2020.Two reviewers independently evaluated and cross checked the quality of the study.Revman 5.3 was used to conduct the meta-analysis.Results:A total of 21 randomized controlled trials with 6,030 patients were included.Meta-analysis showed that the incidence of central venous catheter-related infection(relative risk(RR)=0.29,95%confidence interval(CI)[0.23,0.37]),the incidence of catheter plugging(RR=0.25,95%CI[0.16,0.39])and catheter prolapse(RR=0.18,95%CI[0.11,0.29])were significantly different between the two groups.Conclusion:Cluster nursing intervention could prevent central venous catheter-related infection in intensive care unit.

Clinical analysis on nosocomial pulmonary infection in patients with indwelling tracheal tube

Tracheal intubation by tracheotomy or by placing a tracheal tube through larynx into trachea,is not only one of important measures which are taken to rescue critically ill patients with respiratory failure etc.,but a commonly used method to prevent patients from airway obstruction in the postoperative period and facilitate mechanical ventilation.Meanwhile,the incidence rate of pulmonary infection,a complication caused by indwelling tracheal tubes,especially the incidence rate of hospital acquired pulmonary infection is apparently increasing.Particularly,pulmonary infection of this kind has characteristics of easily recurrent seizures,long treatment period and high drug-resistance.Hence,it is required for medical personnel to summarize,analyze and study not only general nursing,airway nursing and prevention of pulmonary infection,but also antibiotic selection as well as how and when to use those drugs after the incidence of pulmonary infection for the benefit of patients with indwelling tracheal tube.This article is based on a case collected from Comprehensive Surgery Department of the Third Affiliated Hospital of Inner Mongolia Medical University.The patient’s history is as follows:1.Pulmonary infection;2.Indwelling tracheal catheter after tracheotomy;3.Carbon monoxide toxic cerebrosis,mute state.By means of this case analysis,it is expected to make an early detection,and give an early and proper treatment to patients with pulmonary infection caused by indwelling tracheal tubes in clinical practice.

Effect of Cluster Nursing in Preventing Urinary Tract Infection in Postoperative Patients with Indwelling Urinary Catheter

Objective:This paper expounds and analyzes the effect of cluster nursing in preventing urinary tract infection in postoperative patients with indwelling urinary catheter.Methods:A total of 400 postoperative patients with indwelling urinary catheter,treated in Yancheng No.1 People’s Hospital in recent two years,were recruited as research subjects.The patients were equally divided into group A and group B,with 200 patients in each group,and all received routine anti-infectives.The patients in group A(200 cases)received routine nursing.On the basis of group A,cluster nursing was implemented for patients in group B(200 cases).Results:The indwelling time of urinary catheter,the disappearance time of bladder irritation symptoms,and the probability of urinary tract infection were compared between both groups,which showed that the nursing effect of group B was better than that of group A(P<0.05).Conclusion:The implementation of cluster nursing in postoperative patients with indwelling urinary catheter can improve the deficiency of routine nursing,consolidate the treatment effect,and reduce the complication rate of urinary tract infection.

急性阑尾炎手术患儿住院期间切口感染的发生率及相关因素的分析

目的分析急性阑尾炎(AA)手术患儿住院期间切口感染(SSI)发生率及相关因素分析。方法回顾性分析法选择2022年7月至2023年7月68例AA手术患儿的临床资料,依据住院期间是否发生SSI进行分组,将评估出SSiIi者划分为发生组,未评估出感染者则划分为未发生组,收集2组患儿疾病相关.特征、一般资料,分析AA手术患儿住.院期间发生SSI相关因素,通过Logstc回归分析有差异项目。结果68例AA手术患儿中19例发生SSI,发生率为2794%,未发生SS.I共有49例,占比7206%;2组年龄、体征指数(BMI)、性别、基础疾病、切口类型、切口方法、切口保.护、术前CRPi水i平比较发生无统计学意义(P>005),发生组使用预防性抗菌药物、留置腹腔引流管、手术时间、阑尾穿孔和未发生组存在显著差异(P<005);采取Logstc回归方程计算上述有差异的项目,发现使用预防性抗菌药物、留置腹腔引流管、手术时间、阑尾穿孔是AA患儿发生SSI的危险因素。结论AA手术患儿住院期间发生SSI的因素存在多种,如使用预防性抗菌药物、留置腹腔引流管、手术时间、阑尾穿孔,临床需高度引起重视,最大程度降低SSI发生风险。

Prevention of catheter-related Pseudomonas aeruginosa infection by levofloxacin-impregnated catheters in vitro and in vivo

Background Implanted medical catheter-related infections are increasing,hence a need for developing catheter polymers bonded to antimicrobials.We evaluated preventive effects of levofloxacin-impregnated catheters in catheterrelated Psuedomonas aeruginosa （strain PAO1） infection.Methods Drug release from levofloxacin-impregnated catheters was measured in vitro.Levofloxacin-impregnated catheters and polyvinyl chloride （PVC） catheters were immersed in 5 ml 50％ Luria Bertani medium containing 108 CFU/ml Pseudomonas aeruginosa then incubated for 6,12,24 or 48 hours at 37℃ when bacteria adhering to the catheters and bacteria in the growth culture medium were determined.Impregnated and PVC catheters were singly implanted subcutaneously in mice,50 μl （107CFU） of PAO1 was injected into catheters.After the first and fifth days challenge,bacterial counts on implanted catheters and in surrounding tissues were determined microbiologically.Bacterial colonization and biofilm formation on implanted catheters were assessed by scanning electron microscopy.Results Drug release from levofloxacin-impregnated catheters was rapid.Levofloxacin-impregnated catheters had significantly fewer bacteria compared to PVC in vitro.After first and fifth day of challenge,no or significantly fewer bacteria adhered to impregnated catheters or in surrounding tissues compared to PVC.Scanning electron microscopical images after first day displayed from none to significantly fewer bacteria adhering to impregnated implanted catheters,compared to bacteria and microcolonies adhering to PVC catheters.After the fifth day,no bacteria were found on impregnated catheters,compared to clusters surrounding mucus-like substance and coral-shaped biofilms with polymorphonuclear leukocyte on PVC catheters.After the first day of challenge,secretion occurred in all implanted catheters with surrounding tissues mildly hyperaemic and swollen.After the fifth day,minute secretions inside impregnated catheters and no inflammation in tissues,whereas purulent secretion inside PVC catheters and abscesses in surrounding tissues.Conclusion Levofloxacin-impregnated catheter is a promising new strategy for prevention of catheter-related Psuedomonas aeruginosa infection.

项目管理法在内科重症监护病房导尿管相关尿路感染防控中的临床实践

目的通过项目管理法制定预防留置导尿管相关尿路感染(CAUTI)的方案,并评价其在内科重症监护病房(MICU)留置导尿管患者CAUTI防控中的应用效果。方法选择某院MICU收治的153例留置导尿管患者,2021年7月—2022年3月患者为对照组(78例),采用常规方法进行护理;2022年7—12月患者为干预组(75例),采用项目管理法完善的护理措施进行干预。比较两组患者导尿管留置日数、住院日数、CAUTI发生率;同时比较干预组带入导尿管患者与本科室留置导尿管患者在三个质量周期主要指标的差异。结果干预组患者留置导尿管日数短于对照组[(9.51±2.57)d VS(11.10±2.82)d],差异有统计学意义(t=8.207,P=0.038);两组患者住院日数比较,差异无统计学意义(P>0.365)。患者导尿管留置日数:第二质量周期短于第一质量周期,第三质量周期短于第二质量周期,差异均有统计学意义(均P<0.05)。干预组留置导尿管患者CAUTI总体发生率低于对照组(20.00%VS 24.36%),差异有统计学意义(χ^(2)=6.937,P=0.026)。第一、二质量周期:带入与本科留置导尿管患者留置日数比较,差异均有统计学意义(均P<0.05);干预组、第一和第二质量周期:带入与本科留置导尿管患者CAUTI发生率比较,差异均有统计学意义(均P<0.05)。结论应用项目管理法可降低MICU留置导尿管患者CAUTI的发生率,减少留置导尿管日数,提升留置导尿管全流程的护理质量。

关联规则在成人住院病人导尿管相关尿路感染中的应用研究

目的:挖掘成人住院病人导尿管相关尿路感染(CAUTI)事件各变量之间的关系,为临床预防CAUTI的发生提供参考依据。方法:收集某医院2021年1月1日—2023年3月31日上报的144例导尿管相关尿路感染事件发生的数据信息,运用Apriori算法进行关联分析。结果:通过条件设定、结合专业知识评定,最终获得全院导尿管相关尿路感染的强关联规则8条,规则1~3揭示了短期留置导尿管病人发生CAUTI的相关因素、规则4揭示了长期留置导尿管病人发生CAUTI的相关因素、规则5和规则6揭示了意识障碍病人发生CAUTI的相关因素、规则7和规则8揭示了高龄病人发生CAUTI的相关因素。结论:对导尿管相关尿路感染的变量之间进行关联分析,可发现不同条件下发生CAUTI的危险因素,为临床导尿管相关尿路感染事件的发生进行预见性、个性化护理提供了理论依据。

护士主导的预防心血管重症病人导管相关性尿路感染的循证护理实践

目的:探讨以护士主导的预防心血管重症病人导管相关性尿路感染(CAUTI)循证护理实践效果。方法:遵循澳大利亚Joanna Briggs Institute(JBI)循证卫生保健模式,包括证据应用前基线审查、证据应用实践变革以及证据应用后再审查3个阶段。系统检索相关数据库获取预防CAUTI最佳证据,并将证据转化为临床审查标准,制定以护士为主导的预防CAUTI审查标准,比较证据应用前后预防CAUTI护理行为依从性、导尿管留置时长以及护士相关知识掌握情况。结果:证据应用后18条审查指标护理依从性均高于证据应用前,16条审查指标依从性比较差异有统计学意义(P<0.05);导尿管留置时长由证据应用前的(7.94±7.64)d缩短至证据应用后的(5.86±5.63)d(P<0.05);42名护士预防CAUTI知识问卷得分由证据应用前的(64.86±9.59)分提升至证据应用后的(80.21±8.72)分(P<0.05)。结论:以护士为主导最佳证据实践可以提高护理行为的依从性,减少非必要的置管,规范CAUTI护理管理,提升病人照护质量。

髋关节置换术后留置尿管患者尿路感染真菌分布,耐药性及易感因素分析

目的探究髋关节置换术(hip arthroplasty,HA)患者术后留置尿管发生尿路真菌感染的病原菌分布特征、耐药性及易感因素。方法纳入空军军医大学第一附属医院骨科二病区2019年1月—2023年12月收治的1923例HA术后留置尿管患者,根据是否发生尿路真菌感染分为实验组(感染)134例,对照组(未感染)1789例。临床分离非重复真菌菌株,分析HA术后留置尿管发生尿路真菌感染的菌群分布特征;并进行药敏试验,归纳术后留置尿管患者尿路真菌敏感率(S)和耐药率(R)情况;收集临床资料,进行单因素及多因素logistic回归分析,经回归方程拟合的概率值构建风险预测模型。结果134例发生尿路真菌感染的患者中,共收集非重复真菌菌株148株,主要为白念珠菌,占比43.24%(64/148);其次是热带念珠菌,占比22.97%(34/148)。药敏结果显示,除克柔念珠菌对氟康唑天然耐药外,所有真菌对三种唑类抗真菌药物表示不同敏感率,其中伊曲康唑的耐药率最高,敏感性明显低于氟康唑、伏立康唑(P<0.05)。除2种主要检出真菌对5-氟胞嘧啶、两性霉素B保持高敏感率(S>90%),其他真菌对5-氟胞嘧啶、两性霉素B完全敏感(S=100%);所有真菌对卡泊芬净完全敏感(S=100%)。logistic回归分析显示:年龄、留置尿管时间、留置尿管次数、C反应蛋白、降钙素原、(1,3)-β-D葡聚糖、合并糖尿病、抗菌药物使用时间、抗菌药物使用史是HA术后留置尿管致使尿路真菌感染的独立危险因素(P<0.05);ROC分析显示:年龄、留置尿管时间、留置尿管次数、C反应蛋白、降钙素原、(1,3)-β-D葡聚糖、抗菌药物使用时间及联合预测术后真菌感染方面均具有统计学意义(P<0.05);糖尿病、抗菌药物使用史预测术后真菌感染方面均不具有统计学意义(P>0.05)。结论HA术后留置尿管发生尿路真菌感染以白念珠菌为主,年龄、留置尿管时间、留置尿管次数、C反应蛋白、降钙素原、(1,3)-β-D葡聚糖、合并糖尿病、抗菌药物使用时间、抗菌药物使用史是术后真菌感染的独立危险因素。建议根据药敏特点合理使用抗菌药物,并针对上述危险因素采取措施积极预防。

留置导尿患者医院感染危险因素分析

目的 分析留置导尿患者发生医院感染的危险因素和感染的病原菌,为降低留置导尿患者医院感染发生率提供参考。方法 选取甘肃省某三甲医院2021年1-12月发生医院感染的690例住院患者,并匹配690例未发生医院感染的住院患者,筛选有留置导尿操作的340例患者作为研究对象,采用单因素方差分析和二元Logistic回归分析发生医院感染的危险因素。结果 发生医院感染的留置导尿患者[238例(34.49%)]多于未发生医院感染的留置导尿患者[102例(14.78%)],差异具有统计学意义(χ^(2)=72.185,P<0.05)。单因素分析结果显示,放置导尿管时间、中心静脉插管时间、使用呼吸机时间、住院时间、发热时间等18个因素与留置导尿患者发生医院感染有关。多因素分析结果显示,有基础疾病、有侵入性操作(内镜)、进行器官移植、使用血液制品、操作不良事件、抗菌药物数量、住院时间为留置导尿患者医院感染的独立危险因素(P<0.05)。感染病原菌以革兰阴性菌中的鲍曼不动杆菌为主(17.30%)。结论 留置导尿患者医院感染的危险因素是多方面的,在临床实践中,医务人员应重视留置导尿患者的感染风险,针对危险因素制定并落实相应的防控措施。

双J管留置时间对糖尿病合并感染性输尿管结石患者疗效的影响分析

目的 探讨糖尿病合并感染性输尿管结石患者的感染病原菌种类及其耐药性,分析术前留置双J管的时长对治疗效果和术后并发症的影响。方法 回顾性分析2019年1月—2021年2月南京医科大学第四附属医院收治的167糖尿病合并感染性输尿管结石患者临床资料。所有患者均在留置双J管后消除明显感染症状,然后行经皮肾镜取石术或输尿管镜钬激光碎石术。根据双J管留置时间将患者分为对照组(≤7 d)和研究组(>7d),分别为74例和93例。比较两组患者的一般资料、血常规和尿常规检查结果、无石率和术后并发症发生情况,并对所有患者的感染病原菌进行鉴定和药敏试验。结果 本次研究共检出71株感染病原菌,以革兰阴性菌为主(63.38%),其中大肠杆菌、铜绿假单胞菌和金黄色葡萄球菌为最常见的3种。两组患者在一般资料、手术方式、手术时间和平均住院时间方面无统计学差异(P>0.05)。两组患者在留置双J管前和留置双J管后第7天时的尿白细胞水平和血白细胞水平差异无统计学意义,但两组均在留置7 d后较留置前明显降低(P<0.05)。两组患者的术后1个月内无石率相似(P>0.05)。在术后并发症方面,两组患者在暂时性低热、发热、血尿、输尿管穿孔等方面无显著差异,但是尿路刺激征和尿路感染在研究组中明显高于对照组(P<0.05)。结论 术前留置双J管的时长对糖尿病合并感染性输尿管结石患者的治愈率无显著影响,但是较长的双J管留置时间会增加患者术后出现尿路刺激征和尿路感染的风险。

经尿道前列腺电切术留置尿管后尿路感染护理对策分析

目的 探讨经尿道前列腺电切术留置尿管后尿路感染护理对策。方法 将九江市柴桑区人民医院2022年1月至2022年12月70例经尿道前列腺电切术留置尿管后的患者,采用信封随机法分两组。对照组给予常规护理,观察组采取预防性护理。比较两组护理前后不良情绪评分、生活质量评分、炎症指标、满意度、留置尿管时间、住院时间、尿路感染发生率。结果 护理前,两组不良情绪评分、生活质量评分、炎症指标差异无统计学意义(P>0.05);护理后,两组不良情绪评分、生活质量评分、炎症指标均较护理前降低,其中观察组各项评分低于对照组(P<0.05)。观察组满意度高于对照组,留置尿管时间、住院时间短于对照组,尿路感染发生率低于对照组(P<0.05)。结论 经尿道前列腺电切术留置尿管后患者采取预防性护理效果确切,可有效减轻患者不良情绪和控制机体炎症,减少尿路感染的发生,缩短住院时间,提高满意度。

闭式冲洗留置负压引流结合全程冲洗技术治疗颌面间隙感染的效果及对sTREM-1、HMGB-1的影响

目的探讨闭式冲洗留置负压引流结合全程冲洗技术治疗颌面间隙感染的效果及对可溶性髓样细胞触发受体-1(sTREM-1)、高迁移率族蛋白B-1(HMGB-1)的影响。方法选取2020年5月至2022年5月收治的90例颌面间隙感染患者为研究对象,按照随机数字表法将其分为对照组与观察组,各45例。对照组采用传统切开引流术治疗,观察组采用闭式冲洗留置负压引流结合全程冲洗技术治疗。比较两组的治疗效果。结果观察组的治疗总有效率为93.33%,高于对照组的75.56%,差异具有统计学意义(P<0.05)。治疗前,两组的sTREM-1、HMGB-1水平比较,差异无统计学意义(P>0.05);治疗后,观察组的sTREM-1、HMGB-1水平低于对照组,差异具有统计学意义(P<0.05)。治疗前,两组的脓肿直径、张口度、视觉模拟量表(VAS)评分比较,差异无统计学意义(P>0.05);治疗后,观察组的脓肿直径、VAS评分低于对照组,张口度高于对照组,差异具有统计学意义(P<0.05)。结论闭式冲洗留置负压引流结合全程冲洗技术治疗颌面间隙感染,不仅能够提升整体治疗效果,还可降低sTREM-1、HMGB-1水平,减轻肿胀、疼痛及张口受限程度,值得推广。

整体护理在正压留置针封管患儿中的应用效果

目的探讨整体护理在正压留置针封管患儿中的应用效果。方法选取2021年1月至2023年2月西安航天总医院收治的230例正压留置针封管患儿作为研究对象,按照随机数字表法分为研究组(115例)与对照组(115例)。对照组给予常规护理,研究组在对照组基础上给予整体护理,比较两组管腔堵塞与感染发生情况、正压留置针封管固定与维护不合格情况、护理满意度。结果研究组管腔堵塞与感染发生率分别为1.7%、0.9%,低于对照组的8.7%、7.8%,差异有统计学意义(P<0.05)。两组正压留置针封管固定与维护不合格情况比较,差异无统计学意义(P>0.05)。研究组护理总满意率为99.1%,高于对照组的89.6%,差异有统计学意义(P<0.05)。结论整体护理在正压留置针封管患儿中应用可在保持封管质量的基础上,降低管腔堵塞与感染率,提高护理满意度,具有较好的应用价值。

神经外科开颅手术后颅内感染危险因素研究

目的研究神经外科开颅手术后颅内感染的危险因素，为预防提供依据。方法对神经外科开颅手术后的432例患者进行前瞻性调查。结果432例患者中，发生颅内感染67例，感染率为15．51％。留置引流管者颅内感染率为17．05％，较未引流者颅内感染率2．22％之差异有显著性（P〈0．05）；手术时间≤4h者颅内感染率为6．90％，〉4h者颅内感染率为21．32％，两者差异有显著性（P〈0．01）。脑室引流的患者颅内感染率为24．30％，其他部位引流患者颅内感染率为3．68％，两者差异有高度显著性（P〈0．001）。引流管留置1～2d感染率为10．53％，3～4d为30．34％，≥5d为68．97％，三者间差异有高度显著性（P〈0．001）。结论开颅手术后颅内感染与手术持续时间和留置引流管，特别是脑室留置引流管有关。

尿路细菌感染与留置导尿

目的 研究尿路常见细菌及导尿后尿路感染发生及解决的方法。方法 对 2 0 0 1年 6～ 12月 4 4例泌尿外科手术留置尿管的病例进行了前瞻性的研究。结果 分别对尿道口和膀胱尿 (或中段尿 )做细菌培养分离 ,发现本组细菌对多种抗菌药物耐药。结论 尿道口的细菌与尿路感染有关 ;导尿所致尿路感染与导尿管留置的时间有关 ;导尿后尿路感染是可以预防的。