脑血管病患者介入治疗后医院感染病原菌与影响因素分析

Pathogens and risk factors of nosocomial infection in patients with cerebrovascular disease after interventional therapy

  • 摘要: 目的 分析脑血管病患者介入治疗后医院感染病原菌分布与影响因素,并总结预防策略。方法 回顾性分析2015年1月-2017年4月于医院接受介入性治疗的108例脑血管病患者的临床资料,研究对患者进行介入治疗后,发生医院感染患者感染情况及病原菌种类和耐药性,分析患者临床资料,归纳脑血管病患者介入治疗后医院感染的影响因素。结果 108例脑血管病患者介入治疗后发生医院感染21例,感染率为19.44%,以血流感染、呼吸系统感染和泌尿生殖系统感染为主;共培养分离病原菌30株,其中革兰阴性菌20株占66.67%,革兰阳性菌6株占20.00%,真菌4株占13.33%;多因素Logistic回归分析结果显示,基础疾病、气管插管和留置尿管是脑血管病患者经介入治疗后医院感染的影响因素(P<0.05)。结论 脑血管病患者在医院接受介入治疗后发生医院感染的概率较大,医护人员应当根据与医院感染有关的影响因素制定合适的预防措施,降低患者在介入治疗过程中医院感染发生率。

     

    Abstract: OBJECTIVE To analyze the distribution and risk factors of nosocomial infection in patients with cerebrovascular disease after interventional treatment, and to summarize prevention strategies. METHODS The clinical data of 108 patients with cerebrovascular disease who underwent interventional therapy in our hospital from Jan. 2015 to Apr. 2017 were retrospectively analyzed. After the interventional treatment of patients, the infection status as well as the types and drug resistance of pathogens in patients with nosocomial infection was studied. The clinical data of patients were analyzed, and the risk factors of nosocomial infection after interventional therapy in patients with cerebrovascular disease were summarized. RESULTS In 108 patients with cerebrovascular disease, 21 cases of nosocomial infection occurred after interventional therapy, the infection rate was 19.44%. The infections were dominated by bloodstream infection, respiratory infection and genitourinary infection. 30 strains of pathogens were isolated and cultured, of which there were 20 strains of gram-negative bacteria accounting for 66.67%, 6 strains of gram-positive bacteria accounting for 20.00%, and 4 strains of fungi accounting for 13.33%. Multivariate logistic regression analysis showed that basic diseases, tracheal intubation and indwelling catheter were risk factors for nosocomial infection after interventional therapy in patients with cerebrovascular disease (P<0.05). CONCLUSION The patients with cerebrovascular disease have a relatively risk of nosocomial infection after interventional therapy. The medical staff should take appropriate preventive measures based on the risk factors of nosocomial infection, so as to reduce the incidence of nosocomial infection in patients during interventional therapy.

     

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