神经外科高血压脑出血患者医院感染危险因素
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苗传玉

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R181.3+2

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Risk factors for healthcareassociated infection in neurosurgical patients with   hypertensive intracerebral hemorrhage
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    摘要:

    目的研究某院神经外科高血压脑出血住院患者医院感染的危险因素,为医院感染的预防与控制提供依据。 方法对2013年1—12月该院380例高血压脑出血住院患者病历资料进行分析。结果380例患者,发生医院感染36例,医院感染率为9.47%。感染部位居前3位的是下呼吸道、手术切口及泌尿道,分别占50.00%、16.67%、11.11%。共分离病原菌51株,其中革兰阴性杆菌33株(64.71%),革兰阳性球菌18株(35.29%);排名前3位的病原菌依次为表皮葡萄球菌(19.61%)、肺炎克雷伯菌(17.65%)和大肠埃希菌(13.73%)。危险因素分析结果显示,合并基础疾病、侵入性操作、使用呼吸机、长时间使用抗菌药物及住院时间长是导致高血压脑出血患者医院感染的危险因素(均P<0.05)。结论神经外科高血压脑出血患者医院感染率较高,应加强其医院感染监测,并针对危险因素采取有效预防控制措施。

    Abstract:

    ObjectiveTo study the risk factors for healthcareassociated infection (HAI) in neurosurgical patients with  hypertensive intracerebral hemorrhage, and provide the basis for prevention and control of HAI. MethodsClinical data of 380 hospitalized patients with hypertensive intracerebral hemorrhage from January to December 2013 were analyzed.ResultsOf 380 patients, 36 (9.47%) had HAI. The top three sites of infection were lower respiratory tract (50.00%), surgical  incision (16.67%) and urinary tract(11.11%). A total of  51 pathogens were isolated, among which gramnegative bacilli and grampositive cocci accounted for 64.71%(n=33)  and 35.29% (n=18) respectively. The top three pathogens included Staphylococcus aureus (19.61%), Klebsiella pneumoniae (17.65%) and Escherichia coli (13.73%). Risk factors for HAI in hypertensive intracerebral hemorrhage patients were combined underlying diseases, invasive procedures, use of respirator, prolonged use of antimicrobial agents and long length of hospitalization(P<0.05).  ConclusionHAI rate is high in neurosurgical patients with  hypertensive intracerebral hemorrhage, surveillance should be intensified,  and effective preventive and control measures against risk factors  should be taken.

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苗传玉,李岩,贾桂云.神经外科高血压脑出血患者医院感染危险因素[J]. 中国感染控制杂志,2014,13(11):662-664. DOI:10.3969/j. issn.1671-9638.2014.11.006.
MIAO Chuanyu, LI Yan, JIA Guiyun. Risk factors for healthcareassociated infection in neurosurgical patients with   hypertensive intracerebral hemorrhage[J]. Chin J Infect Control, 2014,13(11):662-664. DOI:10.3969/j. issn.1671-9638.2014.11.006.

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  • 收稿日期:2014-06-12
  • 最后修改日期:2014-08-12
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  • 在线发布日期: 2014-11-30
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