神经外科ICU呼吸机相关性肺炎患者合并多重耐药菌感染的影响因素分析  

Analysis of influencing factors of multiple-drug resistant organism infections in patients with ventilatorassociated pneumonia in neurosurgery

作　　者：刘晓慧 杨林凤 钟青 ICU LIU Xiaohui;YANG Linfeng;ZHONG Qing(Ruijin People's Hospital,Ruijin,342500,China)

机构地区：[1]江西省瑞金市人民医院医院感染管理科,342500

出　　处：《护理实践与研究》2023年第20期3084-3089,共6页Nursing Practice and Research

摘　　要：目的 观察神经外科重症监护病房(ICU)呼吸机相关性肺炎(VAP)患者合并多重耐药菌(MDRO)感染情况,分析其影响因素,并针对不同的影响因素提出相应的预防与控制措施。方法 收集2016年4月—2022年3月瑞金市人民医院神经外科ICU VAP住院患者合并MDRO感染的病历资料,采用单因素分析及多因素Logistic回归模型,分析神经外科ICU VAP患者合并MDRO感染的影响因素。结果 多因素Logistic回归模型分析结果显示,ICU住院天数、住院期间最低格拉斯哥昏迷评分(GCS)、中心静脉置管、应用抗菌药物持续时间、应用抗菌药物种类、抗菌药物联合应用、应用第三代头孢菌素是VAP患者合并MDRO感染的影响因素(P<0.05)。其中,ICU住院天数>7 d、住院期间最低GCS评分≤6分、中心静脉置管、应用抗菌药物持续时间>7 d、应用抗菌药物>3种、抗菌药物联合应用的VAP患者更容易合并MDRO感染。结论 神经外科ICU VAP患者合并MDRO感染概率高,ICU住院天数、住院期间最低GCS评分、中心静脉置管、应用抗菌药物持续时间、应用抗菌药物、抗菌药物联合应用均是VAP患者合并MDRO感染的影响因素。Objective To observe the situation of multiple-drug resistant organism(MDRO)infection in ventilator associated pneumonia(VAP)patients in neurosurgery intensive care unit(ICU),analyze its influencing factors,and propose corresponding prevention and control measures according to different influencing factors.Methods We collected the medical records of VAP inpatients with MDRO infection in the neurosurgery ICU of Ruijin People's Hospital from April 2016 to March 2022,and used single-factor analysis and multivariate Logistic regression model to analyze the influencing factors of infection of the VAP patients with MDRO in the neurosurgery ICU.Results Multivariate Logistic regression model analysis showed that the number of days in ICU,the lowest Glasgow coma scale(GCS)score during hospitalization,central venous catheterization,duration of antimicrobial drug use,types of antimicrobial drugs,combined use of antimicrobial drugs,and use of third-generation cephalosporins were the influencing factors for VAP patients complicated with MDRO infection(P<0.05).Among them,the VAP patients who number of days in ICU>7 days,the lowest GCS score≤6 points during hospitalization,central venous catheterization,duration of antimicrobial drug use>7 days,use>3 types of antibacterial drugs or use a combination of antibacterial drugs were more likely to be complicated by MDRO infection.Conclusion The VAP patients in neurosurgery ICU had a high probability of MDRO infection.The number of days in ICU,the lowest GCS score during hospitalization,central venous catheterization,duration of antimicrobial drug use,use of antimicrobial drugs,combined use of antimicrobial drugs,and use of third-generation cephalosporins were the influencing factors for VAP patients complicated with MDRO infection.

关 键 词：神经外科 重症监护病房 呼吸机相关性肺炎 多重耐药菌 影响因素 干预策略 

分 类 号：R47[医药卫生—护理学]