高血压脑出血术后颅内感染的病原菌特征和危险因素分析

目的 分析高血压脑出血术后颅内感染的病原菌特征及其相关危险因素,为临床颅内感染防治提供依据.方法 选择2017年1月-2019年12月在滁州市第一人民医院神经外科行手术治疗的102例高血压脑出血患者为研究对象,回顾性分析其临床资料,观察颅内感染患者的病原菌分布特点,分析颅内感染相关的危险因素.结果 102例高血压脑出血...

Research of the characteristic of pathogenic bacteria and risk factors in intracranial infection after hypertensive cerebral hemorrhage

Objective To analyze the characteristics of pathogenic bacteria and related risk factors of intracranial infection after hypertensive cerebral hemorrhage, and provide a basis for the prevention and treatment of clinical intracranial infection. Methods A total of 102 patients with hypertensive cerebral hemorrhage who were surgically treated in the Neurosurgery Department of the First People’s Hospital of Quzhou from January 2017 to December 2019 were selected as the research subjects. The clinical data were retrospectively collected and analyzed. The distribution of pathogenic bacteria in patients with intracranial infection was observed, and the risk factors related to intracranial infection were analyzed. Results There were 23 cases of intracranial infection in the 102 patients with hypertensive cerebral hemorrhage. Staphylococcus epidermidis was the main gram-positive pathogen, accounting for 25.00%. Acinetobacter baumannii was the main gram-negative pathogen, accounting for 32.14%. The resistance rates of Staphylococcus epidermidis to penicillin, ciprofloxacin, erythromycin, clindamycin, linezolid, vancomycin, and tigecycline were 100.00%, 85.71%, 100.00%, 85.71%, 0.00%, 0.00% and 0.00%, respectively. The resistance rates of Acinetobacter baumannii to piperacillin, ceftazidime, ceftriaxone, imipenem, levofloxacin, compound sinomine and tigecycline were 100.00%, 88.89%, 100.00%, 44.44%, 55.56%, 66.67% and 0.00%, respectively. There were no significant differences in gender, age, BMI, operative time, ASA score, and whether with diabetes between the infected and non-infected patients(all P>0.05), but there were statistical differences in preoperative Glasgow Coma Scale(GCS) scores and whether indwelling ventricle drainage tubes and drainage tube time(all P<0.05). Multivariate analysis showed that preoperative GCS scores and whether indwelling ventricle drainage tubes were independent risk factors for intracranial infection(all P<0.05). Conclusion The main pathogens of intracranial infection after hypertensive intracerebral hemorrhage are mainly Staphylococcus epidermidis and Acinetobacter baumannii, with characteristics of multiple drug resistance. The preoperative GCS score and whether indwelling ventricular drainage tube are independent risk factors for intracranial infection. It needs to be paid enough attention in clinical.