神经内科重症监护病房卒中后鲍曼不动杆菌院内感染的危险因素分析  

Risk Factors of Nosocomial Infection of Acinetobacter Baumannii after Stroke in Intensive Care Unit of Neurology Department

作　　者：龚蕉椒[1] 李锐[1] 郭华 张仲[1] 王蕾[1] 杨敏[1] 

机构地区：[1]重庆医科大学附属成都第二临床学院∥成都市第三人民医院,重庆成都610031

出　　处：《现代医院》2018年第1期90-91,95,共3页Modern Hospitals

基　　金：成都市卫生局课题青年基金(2013074)

摘　　要：目的调查神经内科重症监护病房卒中后患者鲍曼不动杆菌(Acinetobacter baumannii,Ab)院内感染的发病率及危险因素。方法回顾性分析2012年1月—2015年12月入住神经重症监护病房的急性卒中患者Ab的感染率,并分析其危险因素。结果共656例患者入选,64例(9.76%)发生鲍曼不动杆菌感染,发生的首要部位是下呼吸道,其次是泌尿道和上呼吸道。单因素分析显示年龄、侵入性操作、入住NICU时间、抗生素使用、吞咽功能障碍、意识障碍、入院时美国国立卫生研究院卒中量表(NIHSS)评分与AB院内感染相关。多因素分析表明入住NICU时间、年龄、吞咽功能障碍、NIHSS评分是AB院内感染的独立预测因素。结论神经内科重症监护病房卒中后AB院内感染的独立预测因素为入住NICU时间、年龄、吞咽功能障碍和NIHSS评分。Objective To investigate the incidence rate and risk factors of nosocomial infection of acinetobacter baumannii in patients after stroke in intensive care unit of neurology department. Methods We retrospectively reviewed the AB infection rate of patients with acute stoke admitted in NICU from January 2012 to December 2015 and analyzed its risk factors. Results A total of 656 patients were selected and 64 patients( 9. 76%) developed AB infection. The lower respiratory tract had a highest rate of AB infection,followed by urinary tract and upper respiratory tract. The univariate analysis showed that age,invasive operation,hospitalization time in NICU,application of antibiotic,swallowing dysfunction,disturbance of consciousness,NIHSS score were related with AB nosocomial infection. Multivariate analysis showed that hospitalization time in NICU,age,swallowing dysfunction,NIHSS score were independent predictors of AB nosocomial infection. Conclusion The independent predictors of AB nosocomial infection after stroke in NICU are hospitalization time in NICU,age,swallowing dysfunction and NIHSS score.

关 键 词：鲍曼不动杆菌 脑卒中 院内感染 相关因素 

分 类 号：R181.32[医药卫生—流行病学]