老年胸腰椎脊柱手术术后深部感染耐甲氧西林革兰阳性菌的临床特征及风险预测模型构建  

Clinical characteristics of deep methicillin-resistant Gram-positive bacteria infection in the elderly after thoracolumbar spine surgery and construction of risk prediction model

作　　者：杨玲娟 胡文跃 王潇潇 韩磊 周化腾 YANG Ling-juan;HU Wen-yue;WANG Xiao-xiao;HAN Lei;ZHOU Hua-teng(Department of Orthopedics and Traumatology,Xiaoshan District Hospital of Traditional Chinese Medicine,Hangzhou,Zhejiang311200,China)

机构地区：[1]杭州萧山区中医院骨伤科,浙江杭州311200

出　　处：《中国卫生检验杂志》2022年第20期2512-2515,2521,共5页Chinese Journal of Health Laboratory Technology

基　　金：2021年浙江省卫生健康科技计划-2021年省卫生健康创新人才项目(2021RC026)。

摘　　要：目的观察老年胸腰椎脊柱手术术后深部感染耐甲氧西林革兰阳性菌的临床特征及风险预测模型构建。方法选取2019年2月—2021年12月本院行胸腰椎脊柱手术的老年患者261例,其中术后发生深部感染并检出耐甲氧西林革兰阳性菌患者72例(观察组),未发生感染患者189例(对照组),分析观察组术后深部感染耐甲氧西林革兰阳性菌临床特征,并构建术后深部感染风险预测模型。结果共培养出耐甲氧西林革兰阳性菌90株,其中占比较高菌株为耐甲氧西林金黄色葡萄球菌(45株)。预测模型为Logit(P)=0.654-1.570×肥胖-0.807×糖尿病+-1.058×手术方式+0.654×术后引流管留置时间,该模型预测患者术后深部感染发生曲线下面积为0.747(P<0.05)。结论患者感染病原菌以耐甲氧西林金黄色葡萄球菌为主,肥胖、糖尿病、开放手术、术后引流管留置时间是患者术后深部感染的独立危险因素。Objective To observe the clinical characteristics of deep methicillin-resistant Gram-positive bacteria infection in the elderly after thoracolumbar spine surgery,and construct a risk prediction model.Methods A total of 261 elderly patients who underwent thoracolumbar spine surgery in the hospital between February 2019 and December 2021 were recruited.After operation,there were 72 patients with deep methicillin-resistant Gram-positive bacteria infection(observation group)and189 patients without infection(control group).The clinical characteristics of the observation group were analyzed,and a risk prediction model for deep infection was constructed.Results A total of 90 methicillin-resistant Gram-positive bacteria strains were obtained,and the proportion of methicillin-resistant Staphylococcus aureus was higher(45 strains).The risk prediction model was as follows:Logit(P)=0.654-1.570×obesity-0.807×diabetes+-1.058×surgical method+0.654×postoperative drainage tube indwelling time.The area under the curve of this model to predict deep infection was 0.747(P<0.05).Conclusion Methicillin-resistant Staphylococcus aureus is the main pathogenic bacteria of deep infection in the elderly after thoracolumbar spine surgery.Obesity,diabetes,open surgery and postoperative drainage tube indwelling time are independent risk factors for deep infection in the elderly after thoracolumbar spine surgery.

关 键 词：胸腰椎 手术 感染 革兰阳性菌 临床特征 风险预测 

分 类 号：R446[医药卫生—诊断学]