神经外科住院患者泛耐药鲍氏不动杆菌感染的调查分析  

Investigation and analysis of pan-resistant Acinetobacter baumanniiinfections in hospitalized patients of neurosurgery department

作　　者：金瑛[1] 叶丹[1] 吴玉琴[1] 

机构地区：[1]浙江中医药大学附属第二医院护理部,浙江杭州310005

出　　处：《中华医院感染学杂志》2013年第8期1806-1808,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨神经外科重症监护病房(NICU)住院患者发生泛耐药鲍氏不动杆菌(PDRAB)医院感染及其预防措施。方法对2008年7月-2012年7月入住NICU 100例PDRAB感染患者进行调查,采用单因素及多因素logistic回归分析法对PDRAB医院感染因素进行分析。结果共检出PDRAB 142株,主要来自痰液74株占52.11%,经单因素分析结果显示,格拉斯哥昏迷(GCS)评分、血白蛋白、机械通气及头部引流管为PDRAB感染的危险因素(P<0.05);GCS评分(OR=6.52,95%CI为1.83～18.09,P<0.0001)、血白蛋白(OR=1.82,95%CI为0.51～6.12,P<0.05)及头部引流管(OR=1.72,95%CI为1.21～1.73,P<0.05)是PDRAB医院感染的独立危险因素(P<0.05)。结论在危险因素GCS评分待定时,应注意加强NICU的PDRAB患者的营养供给,及早地拔除引流管等措施,能够显著地降低感染率及病死率。OBJECTIVE To explore the pan-resistant Acinetobacter baumannii（PDRAB） infections in the neurosurgery intensive care unit（NICU） so as put forward the prevention measures of the PDRAB infections.METHODS A total of 100 cases of patients suffering from the PDRAB infections,who enrolled in the NICU from Jul 2008 to Jul 2012,were surveyed.The univariate analysis and the multivariate logistic regression analysis were employed to analyze the cases of the PDRAB infections.RESULTS A total of 142 strains of PDRAB were detected,among which 74（52.11%） strains were isolated from the sputum.The univariate analysis indicated that the GCS scores,serum albumin,mechanical ventilation,and head drainage tube were the risk factors of the PDRAB infections（P0.05）.The GCS score（OR=6.52,95%CI as 1.83-18.09,P0.0001）,serum albumin（OR=1.82,95%CI as 0.51-6.12,P0.05） and head drainage tube（OR=1.72,95%CI as 1.21-1.73,P0.05）were the independent risk factors of the PDRAB infections（P0.05）.CONCLUSION While the risk factor GCS scores being determined,it is necessary to strengthen the nutrition supply for the PDRAB infection patients in NICU and extubate in a timely manner so as to significantly reduce the incidence of the infections and the mortality.

关 键 词：神经外科 泛耐药鲍氏不动杆菌 感染 格拉斯哥昏迷评分 

分 类 号：R181.32[医药卫生—流行病学]