Analysis on risk factors for multidrug-resistant bacterial infections in patients in neurosurgical intensive care unit / 中国医师杂志

ABSTRACT

Objective To analyze the risk factors of multidrug-resistant bacteria (MDRO) infection in patients in Neurosurgical intensive care unit (NSICU),and to provide reference for clinical prevention and treatment.Methods 1 251 patients with NSICU in our hospital from January 2012 to March 2018 were selected as the study subjects.The bacterial specimens were extracted.380 patients with MDRO infection were the observation group,and 871 patients with non-MDRO infection in NSICU were the control group.The patients'medical records and clinical information were retrospectively analyzed,and multivariate logistic regression analysis was used to analyze the risk factors of MDRO infection in NSICU patients.Results There was no significant difference in the gender,age and body mass index (BMI) between the observation group and the control group (P ＞ 0.05).There was statistical significance in the proportion of hospitalization time,operation,use of urethra tube,mechanical ventilation,serious basic diseases and rational use of antibiotics between the observation group and the control group (P ＜ 0.05).According to the analysis on proportion of colony samples,the highest proportion in the observation group was sputum samples,accounted for 45.00％,followed by urine samples (21.58％),and the lowest proportion was other types of samples,accounted for 1.84％.The results of MDRO test showed that the highest proportion of pathogens was methicillin-resistant staphylococcus aureus (MRSA),accounted for 33.69％,followed by pseudomonas aeruginosa (PA),carbapenem-resistant acinetobacter baumannii (CR-AB),and the lowest proportion was stenotrophomonas maltophilia (SM),accounted for 1.58％.Logistic regression analysis showed that surgery,catheterization,mechanical ventilation,serious basic diseases and abuse of antibiotics were risk factors for MDRO infection in NSICU patients (P ＜ 0.05).Conclusions Invasive manipulation and antimicrobial abuse are the main risk factors for MDRO infection in NSICU patients,among which respiratory tract infection is the most serious and MRSA strain infection is the most common.The management of drugs and therapeutic devices should be scientific,rational and standardized in order to reduce the infection rate of MDRO.