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中华实验和临床感染病杂志(电子版) ›› 2017, Vol. 11 ›› Issue (03) : 228 -231. doi: 10.3877/cma.j.issn.1674-1358.03.005

临床论著

神经外科重症患者脑室外引流相关感染危险因素分析
王凯1, 徐跃峤1,(), 王宁1, 陈文劲1, 程玮涛1   
  1. 1. 100053 北京,首都医科大学宣武医院神经外科
  • 收稿日期:2016-05-27 出版日期:2017-06-15
  • 通信作者: 徐跃峤
  • 基金资助:
    北京市卫生系统高层次卫生技术人才培养项目(No. 2015-3-062)

Risk factors for infections related to external ventricular drainage in Neurosurgery Intensive Care Unit

Kai Wang1, Yueqiao Xu1,(), Ning Wang1, Wenjin Chen1, Weitao Cheng1   

  1. 1. Department of Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
  • Received:2016-05-27 Published:2017-06-15
  • Corresponding author: Yueqiao Xu
引用本文:

王凯, 徐跃峤, 王宁, 陈文劲, 程玮涛. 神经外科重症患者脑室外引流相关感染危险因素分析[J/OL]. 中华实验和临床感染病杂志(电子版), 2017, 11(03): 228-231.

Kai Wang, Yueqiao Xu, Ning Wang, Wenjin Chen, Weitao Cheng. Risk factors for infections related to external ventricular drainage in Neurosurgery Intensive Care Unit[J/OL]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2017, 11(03): 228-231.

目的

探讨脑室外引流(EVD)相关感染的发病率及其危险因素。

方法

收集本院神经外科监护室2015年1月1日~2015年12月31日行EVD的58例患者临床资料,对脑室感染发病率、抗菌药物使用、合并感染、致病菌、导管引流时间、留取脑脊液标本频率等进行回顾性分析。其中蛛网膜下腔出血/脑出血患者48例,颅脑肿瘤患者7例,其他疾病3例;预防性使用抗菌药物患者25例。

结果

共纳入58例患者、456个导管日的资料,感染率为8.6%,10.9/1 000导管日,导管引流时间(≥11 d,Wals = 4.8、RR = 17.3、95%CI:1.4~218.3、P = 0.028)、留取脑脊液标本频率(≤ 2 d,Wals = 5.3、RR = 15.3、95%CI:1.5~243.7,P = 0.022)以及合并肺部感染(RR = 7.8、95%CI:0.8~74.8,P = 0.04)均为EVD相关感染的危险因素。

结论

导管引流时间长、留取脑脊液标本频率高以及合并肺部感染可能增加EVD相关感染风险。

Objective

To investigate the infection rates and risk factors associated with external ventricular drainage (EVD) related infection in Neurosurgery Intensive Care Unit (NICU).

Methods

Total of 58 patients with EVD in NICU of Xuanwu Hospital of Capital Medical University, during 1st January 2015 to 31th December 2015 were collected. Patients and disease demographics, EVD data, antibiotic treatment, the EVD related and concomitant infection, duration of drainage and CSF sampling frequency were analyzed, retrospectively. There were 48 patients with subarachnoid hemorrhage/intracranial hemorrhage; 7 patients with intracranial tumor; 3 patients with other disease. Total of 25 patients were administrated antibiotics prophylactically.

Results

Total of 58 patients, 456 catheter-days were evaluated. The incidence of infection was 8.6% and the drain-associated infection rate was 10.9 per 1 000 catheter-days. Duration of EVD drainage (≥ 11 days; Wals = 4.8, RR = 17.3, 95%CI: 1.4-218.3, P = 0.028), CSF sampling frequency (≤ 2 days; Wals = 5.3, RR = 15.3, 95%CI : 1.5-243.7, P = 0.022) and concomitant pulmonary infection (RR = 7.8, 95%CI : 0.8-74.8, P = 0.04) were all the related risk factors.

Conclusions

The duration of drainage, CSF sampling frequency and pulmonary infection may increase the EVD related infection.

表1 EVD相关感染危险因素分析
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