颅内动脉瘤介入治疗后医院感染的影响因素及病原学分析

Risk factors and etiology of nosocomial infection after intracranial aneurysm interventional therapy

  • 摘要: 目的 探讨动脉瘤颅内介入治疗后医院感染的影响因素及病原学特点。方法 回顾性分析2014年5月-2017年9月于医院接受颅内动脉瘤介入治疗的680例患者的临床资料,统计患者治疗后发生医院感染的情况,分析感染患者的病原学特点,收集患者的年龄、吸烟史、留置胃管、白细胞计数、血清白蛋白水平、血糖水平等临床资料进行单因素分析,再行多因素logistic回归分析患者发生医院感染的影响因素。结果 入组680例患者中,发生医院感染患者122例,感染率为17.94%。在感染部位分布方面,以肺部感染为主,62例占50.82%,其次为尿道感染25例占20.49%; 122例感染患者,经细菌学检查分离病原菌共138株,其中革兰阴性菌97株占70.29%、革兰阳性菌26株占18.84%、真菌15株占10.87%; 多因素Logistic回归分析结果显示,年龄≥65岁、留置胃管、有吸烟史、白细胞计数升高、白蛋白低及GCS评分过低是患者发生医院感染的影响因素(P<0.05)。结论 对于动脉瘤颅内介入治疗后患者,发生医院感染的影响因素较多,应采取有针对性的预防对策,并合理选择抗菌药物,降低医院感染的发生率。

     

    Abstract: OBJECTIVE To explore the influencing factors and pathogenic characteristics of nosocomial infection after intracranial interventional therapy for aneurysms. METHODS The clinical data of 680 patients who underwent interventional treatment of intracranial aneurysms in hospital from May 2014 to Sep.2017 were retrospectively analyzed.The incidence of nosocomial infection after treatment was analyzed.The pathogenic characteristics of infected patients were analyzed.The clinical data of age, smoking history, indwelling gastric tube, white blood cell count, serum albumin level and blood glucose level were analyzed by univariate analysis, and multivariate logistic regression was used to analyze the influencing factors of nosocomial infection. RESULTS Among the 680 patients enrolled, 122 cases of nosocomial infection occurred, and the infection rate was 17.94%.In the distribution of infection sites, pulmonary infection was the main cause, with 62 cases accounting for 50.82%, followed by urinary tract infection, with 25 cases accounting for 20.49%.In the 122 cases of infected patients, 138 strains were isolated by bacteriological examination, including 97 strains of gram-negative bacteria, accounting for 70.29%, 26 strains of gram-positive bacteria accounting for 18.84%, and 15 strains of fungi accounting for 10.87%.Multivariate logistic regression analysis showed that age ≥ 65 years old, indwelling gastric tube, smoking history, elevated white blood cell count, low albumin and low GCS scores were the influencing factors of nosocomial infection (P<0.05). CONCLUSION For patients after aneurysm interventional therapy, there are many influencing factors of nosocomial infection.Targeted preventive measures should be taken, and antibiotics should be rationally selected to reduce the incidence of nosocomial infection.

     

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