神经外科病人血流多重耐药菌感染危险因素分析

目的 探讨神经外科病人发生血流多重耐药菌（MDR）感染特点与危险因素，为临床防治提供参考。方法 回顾性分析2013年7月至2018年1月神经外科收治的217例血流感染的临床资料，采用多因素Logistic回归分析检验MDR感染危险因素。结果 MDR感染率为23.96%。多因素Logistic分析显示，手术治疗、深静脉置管、机械通气、留置导尿、联用抗菌药物≥3种、抗菌药物使用时间≥14 d等6个因素是神经外科病人MDR血流感染的独立危险因素（P<0.05）。结论 神经外科病人MDR血流感染检出率较高，与多种危险因素有关，其中减少不必要的各种侵入性诊疗操作与合理使用抗菌药物是降低神经外科病人血流MDR感染的重要措施。

Analysis of risk factors of multidrug-resistant bacteria blood stream infection in nerosurgical patients

Objective To investigate the characteristics and risk factors of multi-drug resistant bacteria (MDRB) blood stream infections in the neurosurgical patients. Methods The clinical data of 217 patients with MDRB blood stream infections treated in Neurosurgical Department from July, 2013 to January, 2018 were analyzed retrospectively. The risk factors related to MDRB blood stream infection were statistically analyzed by SPSS17.0 software. Results The rate of MDRB blood stream infection was 23.96%. The multivariate logistic analysis showed that the risk factors related to MDRB blood stream infection included surgical interventions, mechanical ventilation, catheterization into the deep veins, indwelling catheterization, combined use of antibiotics ≥3 types and antibacterial use duration ≥14 days. Conclusions The rate of MDRB blood stream infection is high in the neurosurgical patients. The surgical treatment, catheterization into the deep veins, mechanical ventilation, indwelling catheterization, combined use of antibiotics ≥3 types, and antibiotic use duration ≥14 day are major risk factors of MDRB blood stream infections in the neurosurgical patients.