神经内科ICU住院病人多重耐药菌的病原学特点及危险因素  

Pathogenic characteristics and risk factors of multi-drug resistant organism in hospitalized patients in neurology ICU

作　　者：路晓芸 张银萍[2] 沈丽 孙惠英 张鹏亮 杨诏旭 LU Xiaoyun;ZHANG Yinping;SHEN Li;SUN Huiying;ZHANG Pengliang;YANG Zhaoxu(The First Affiliated Hospital of Air Force Military Medical University,Shaanxi 710032 China;Xi'an Jiaotong University)

机构地区：[1]中国人民解放军空军军医大学第一附属医院,陕西710032 [2]西安交通大学

出　　处：《护理研究》2025年第7期1094-1100,共7页Chinese Nursing Research

基　　金：空军军医大学第一附属医院2019年度学科助推计划,编号:XJZT19ML43。

摘　　要：目的:分析神经内科重症监护室(ICU)住院病人多重耐药菌(MDRO)的病原学特点及发生的危险因素,为神经内科ICU的多重耐药菌防控提供依据。方法:回顾性分析2019年1月1日—2022年12月31日某三级甲等综合医院神经内科1 003例ICU住院病人的资料,利用Logistic回归分析多重耐药菌感染的危险因素。结果:363例病人检出多重耐药菌,以鲍曼不动杆菌[274株(51.41%)]为主,其次为肺炎克雷伯菌[92株(17.26%)]及金黄色葡萄球菌[85株(15.95%)],鲍曼不动杆菌连续4年检出率排名第1位;标本主要分布于痰液(82.55%),其次为尿液(15.20%);多重耐药菌医院感染部位以下呼吸道为主;Logistic回归分析结果显示,抗生素使用天数、白细胞计数、留置导尿管是神经内科ICU病人检出多重耐药菌的影响因素。结论:神经内科ICU病人病情复杂,病程长,易检出多重耐药菌,根据多重耐药菌病原学特点及发生的危险因素精准制定预防措施,有助于降低多重耐药菌感染率,提高诊疗效果。UniversityAbstract Objective:To analyze the pathogenetic characteristics of multi-drug resistant organism(MDRO) and the risk factors for theiroccurrence in patients hospitalized in neurology intensive care unit(ICU),and to provide a theoretical basis for the prevention and controlof MDRO in neurology ICU.Methods:1 003 patients hospitalized in the neurology ICU of a tertiary grade A hospital from January 1,2019 to December 31,2022 were retrospectively analyzed,and the risk factors of MDRO were detected using logistic regression analysis.Results:MDRO were detected in 363 patient cases,with Acinetobacter baumannii[274 strains(51.41%)] predominating,followed byKlebsiella pneumoniae[92 strains(17.26%)] and Staphylococcus aureus[85 strains(15.95%)].And Acinetobacter baumannii rankedNo.1 in terms of the detection rate for the fourth consecutive year;the specimens were mainly distributed in sputum(82.55%),followedby urine(15.20%);the site of hospital infection of MDRO was mainly in the lower respiratory tract.Results of logistic regressionanalysis showed that the number of days of antibiotic use,leukocyte count,and indwelling urinary catheter were the influencing factors ofMDRO detected in neurology ICU patients.Conclusion:Neurology ICU patients with complex conditions and long duration of illnessare prone to detect MDRO.And the precise formulation of preventive measures according to the pathogenetic characteristics of MDROand the risk factors for their occurrence,which can help to reduce the rate of MDRO infections and improve the effectiveness of diagnosisand treatment.

关 键 词：神经内科重症监护室 多重耐药菌 病原学 危险因素 

分 类 号：R47[医药卫生—护理学]