神经外科术后产超广谱β-内酰胺酶肺炎克雷伯菌感染的风险因素分析  

Risk factors of infection after neurosurgery induced by extended-spectrumβ-lactamases producing Klebsiella pneumoniae

作　　者：钱玲烨 郑光辉[1] 史一君 李国歌 Osman Rasha Alsamani 张国军[1] Qian Lingye;Zheng Guanghui;Shi Yijun;Li Guoge;Osman Rasha Alsamani;Zhang Guojun(Clinical Laboratory,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院检验科,北京100070

出　　处：《国际流行病学传染病学杂志》2020年第6期534-538,共5页International Journal of Epidemiology and Infectious Disease

摘　　要：目的探究神经外科术后产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌感染的风险因素。方法收集2012年1月至2019年5月在某医院接受神经外科手术后感染肺炎克雷伯菌的患者病历资料。选取15个临床变量,通过多因素Logistic分析患者术后感染的风险因素。结果72例术后感染患者中,共分离出肺炎克雷伯菌菌株91株,其中产ESBLs肺炎克雷伯菌42株。多因素Logistic分析显示,呼吸机的使用[OR(95%CI)=20.627(2.795~152.233)]和开颅手术[OR(95%CI)=13.658(1.618~115.298)]是神经外科术后产ESBLs肺炎克雷伯菌感染的独立风险因素。结论神经外科术后产ESBLs肺炎克雷伯菌感染可导致严重后果,呼吸机的使用和开颅手术作为其独立风险因素,应予重视。Objective To explore the risk factors of post-neurosurgical infections caused by extended-spectrumβ-lactamases(ESBLs)producing Klebsiella pneumonia.Methods Clinical data of patients confirmed post-neurosurgical infection with Klebsiella pneumonia in one hospital from January 2012 to May 2019 was collected.A total of 15 clinical variables were extracted and evaluated to find the risk factors of postoperative infection by multivariate Logistic analysis.Results There were 91 strains of Klebsiella pneumoniae isolated from 72 patients with post-neurosurgical infection,including 42 strains of ESBLs producing Klebsiella pneumoniae.Multivariate Logistic analysis showed that use of ventilator(OR=20.627,95%CI:2.795-152.233)and craniotomy(OR=13.658,95%CI:1.618-115.298)were independent risk factors that caused infection after neurosurgery induced by ESBLs producing Klebsiella pneumoniae.Conclusions Postoperative infection induced by ESBLs producing Klebsiella pneumoniae may lead to serious consequences.As the independent risk factors of the infection,use of ventilator and craniotomy should be paid attention clinically.

关 键 词：克雷伯菌 肺炎 Β-内酰胺酶类 术后感染 风险因素 

分 类 号：R446.5[医药卫生—诊断学] R651[医药卫生—临床医学]