摘要
目的探讨脊柱手术患者术后发生医院感染的影响因素及应对措施。方法回顾性选取我院2022年1月-2023年12月收治的脊柱手术患者706例,依据《英国NHS医院——预防医院感染循证指南(Ⅰ)》分为发生医院感染组(35例)和未发生医院感染组(671例)。统计发生医院感染组术后感染病原菌构成情况。对脊柱手术患者术后医院感染进行单因素和多因素分析,构建预测模型。结果35例发生医院感染患者中检出44株病原菌,真菌占4.55%,革兰阴性菌占52.27%,革兰阳性菌占43.18%。发生医院感染组糖尿病、置入材料占比及降钙素原(PCT)水平高于未发生医院感染组(P<0.05)。多因素Logistic回归分析结果显示,糖尿病(OR=43.293,95%CI 15.411-121.622)、置入材料(OR=6.184,95%CI 2.678-14.281)、PCT水平较高(OR=1.388,95%CI 1.155-1.669)均是术后发生医院感染的影响因素(P<0.05)。logit(P)=-10.522+糖尿病×3.768+置入材料×1.822+PCT×0.328。预测模型预测脊柱手术患者术后发生医院感染AUC值为0.898,敏感度为92.96%,特异度为69.29%。结论脊柱手术患者术后发生医院感染主要病原菌为革兰阴性菌和革兰阳性菌,主要影响因素为糖尿病、置入材料、PCT水平较高,临床可用于脊柱手术患者术后发生医院感染预测。
Objective To explore the influencing factors and countermeasures of nosocomial infection in patients with spinal surgery.Methods 706 spinal surgery patients admitted to our hospital from January 2022 to December 2023 were retrospectively selected and divided into a nosocomial infection group(35 cases)and a nosocomial infection group(671 cases)according to the“Evidence-based Guidelines for the Prevention of Nosocomial infection in NHS Hospitals(Ⅰ)”.The pathogenic bacteria composition of postoperative infection in nosocomial infection group were analyzed.The prediction model of postoperative nosocomial infection in patients undergoing spinal surgery was constructed by univariate and multivariate analysis.Results 44 strains of pathogenic bacteria were detected in 35 patients with nosocomial infection,including fungi(4.55%),gram-negative bacteria(52.27%)and gram-positive bacteria(43.18%).Patients with nosocomial infection had higher levels of diabetes,the proportion of implanted materials and procalcitonin(PCT)than those without nosocomial infection(P<0.05).Multivariate Logistic regression analysis showed that diabetes mellitus(OR=43.293,95%CI 15.411-121.622),implant material(OR=6.184,95%CI 2.678-14.281),PCT level was higher(OR=1.388,95%CI 1.155-1.669)were the influential factors for postoperative nosocomial infection(P<0.05).logit(P)=-10.522+diabetes×3.768+implant material×1.822+PCT×0.328.The AUC value of postoperative nosocomial infection predicted by the prediction model was 0.898,the sensitivity was 92.96%,and the specificity was 69.29%.Conclusion The main pathogens of postoperative nosocomial infection in patients with spinal surgery are Gram-negative bacteria and Gram-positive bacteria,and the main influencing factors are diabetes,implant materials and high level of PCT,which can be used to predict postoperative nosocomial infection in patients with spinal surgery.
作者
马洋洋
Ma Yangyang(Zengcheng Campus,Southern Hospital,Southern Medical University,Guangzhou,Guangdong 511340,China)
出处
《首都食品与医药》
2024年第21期24-27,共4页
Capital Food Medicine
关键词
脊柱手术
医院感染
糖尿病
PCT
影响因素
应对措施
spinal surgery
Hospital infection
Diabetes
PCT
Influencing factors
Coping measures
