Risk factors of multi drug resistant bacteria infection in neurosurgery patients with pulmonary infection
神经外科合并肺部感染患者多重耐药菌感染的危险因素分探究

摘要

目的 详细探讨神经外科合并肺部感染患者多重耐药菌感染感染（MDR）相关危险因素，以此来为临床防控和院感防控提供参考。方法 筛选我院200例神经外科合并肺部感染患者临床资料进去详细统计（2020年6月至20221年7月21日），根据MDR菌检出结果将患者均分为观察组（n=100）和对照组（n=100）。深入分析两种病原学特征，对于两种患者肺炎克莱伯菌、鲍曼不动杆菌耐药性差异进行对比。针对神经外科合并肺部感染患者多重耐药菌感染卫生因素进行回归分析。结果 与对照组相比较，观察组患者肺炎克雷伯菌、鲍曼不动杆菌抗菌药物耐药率明显更高，P＜0.05。且根据合格分析发现，神经外科合并肺部感染多重耐药菌主要有住院时间超过30d、年龄超过65岁、营养不良、非限制类抗菌药物使用时间超过7d等。结论 在临床治疗神经外科合并肺部感染疾病的过程中如存在卧床、营养不良或贫血、住院时间超过30d、高龄、抗菌的药物使用超过7d非常容易出现MDR菌感染现象。因此针对临床存在高危因素患者应该定期开展筛查，并采取多种措施进行综合干预，这样才能对院内MDR菌感染进行有效预防。

Abstract

Objective To investigate the risk factors of multidrug resistant bacterial infection (MDR) in neurosurgery patients with pulmonary infection, so as to provide reference for clinical prevention and control and hospital infection prevention and control.
Methods The clinical data of about 200 neurosurgery patients with pulmonary infection were collected in detail (from June 2020 to July 21, 20221). The patients were divided into the observation group (n=100) and the control group (n=100) according to the MDR bacteria detection results. In-depth analysis of the two pathogenic characteristics, for two patients with klebsiella pneumoniae, acinetobacter baumannii drug resistance differences were compared. Regression analysis was conducted to analyze the health factors of multiple drug resistant bacteria infection in neurosurgery patients with pulmonary infection.
Results Compared with the control group, the antibiotic resistance rate of Klebsiella pneumoniae and Acinetobacter baumannii in the observation group was significantly higher (P<0.05). According to the qualified analysis, the multi drug resistant bacteria in neurosurgery combined with pulmonary infection mainly include hospitalization time over 30 days, age over 65 years, malnutrition, and use of non restricted antibiotics for more than 7 days.
Conclusion   In the course of clinical treatment of neurosurgery patients with pulmonary infection, MDR infection is very likely to occur if there are bedridden, malnutrition or anemia, hospital stay more than 30 days, old age, and antibacterial drug use more than 7 days. Therefore, screening should be carried out regularly for patients with high risk factors, and multiple measures should be taken for comprehensive intervention, so as to effectively prevent MDR infection in the hospital.