Infection sites,pathogen distribution and influencing factors of nosocomial infection after craniocerebral surgery
Objective To investigate the infection sites,pathogen distribution and risk factors of nosocomial infection after craniocerebral surgery.Methods This is a case-control study.Eighty patients with a mean age of(63.2±8.2)years who developed hospital acquired infections after craniocerebral treatment at Suzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2018 to December 2021 were assigned to infection group.Eighty patients with a mean age of(61.7±7.8)years who underwent craniocerebral surgery during the same period but did not develop hospital acquired infections were allocated to control group.The medical records and laboratory examination data of the patients were reviewed.Infection sites and pathogen characteristics in patients with hospital acquired infections after craniocerebral surgery were analyzed.Univariate and multivariate analyses were used to explore the risk factors for hospital acquired infections after craniocerebral surgery.Results The respiratory system was mainly infected in the 80 patients with hospital acquired infection after craniocerebral surgery(58.75%),followed by urinary system(22.50%).The main pathogenic bacteria in patients with respiratory system,urinary system and nervous system infections were Gram-negative bacteria.Gram-negative and Gram-positive bacteria in patients with blood system infection accounted for 50%,respectively.There was no significant difference in the composition of pathogenic bacteria among patients with infections in different parts of the body(P>0.05).In 51 patients with Gram-negative bacterial infections,the main pathogenic bacteria were Escherichia coli(26.25%)and Acinetobacter baumannii(15.00%).In 29 patients with Gram-positive bacterial infections,the main pathogenic bacteria were Staphylococcus aureus(16.25%)and Enterococcus faecalis(11.25%).Logistic regression model showed that non class Ⅰ incision,external ventricular drainage,cerebrospinal fluid leakage,non-prophylactic use of antibiotics before surgery,and indwelling catheter were independent risk factors for infection related complications in patients undergoing craniocerebral surgery(all P<0.05).Conclusion The respiratory system and urinary system are mainly involved in patients with nosocomial infection after craniocerebral surgery.The main pathogenic bacteria are Gram-negative bacteria.Non class Ⅰ incisions,external ventricular drainage,leakage of cerebrospinal fluid,non-prophylactic use of antibiotics before surgery,and indwelling catheter may increase the risk of postoperative infection.
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