Analysis of pathogenic bacteria and influencing factors of death in patients with severe neurological pulmonary infection
10.3760/cma.j.cn431274-20210514-00539
- VernacularTitle:神经重症合并肺部感染患者的病原体及死亡影响因素分析
- Author:
Chunhui LI
1
;
Xiuyue MAO
;
Xiao ZHU
;
Tao CHEN
;
Huan LI
;
Jinbing GONG
;
Gang LUO
;
Jianbai YU
;
Libo LI
Author Information
1. 湖南中医药大学第一附属医院神经外科，长沙 410007
- Keywords:
Risk factors;
Intensive care units, neurosurgery;
Pulmonary infection;
Microbial sensitivity tests
- From:
Journal of Chinese Physician
2022;24(6):859-862,870
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the distribution of respiratory pathogens and risk factors of death in patients with pulmonary infection in neurosurgical intensive care unit (NICU).Methods:A total of 87 patients with pulmonary infection in the NICU of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from January 2018 to December 2019 were collected, and the pathogens of their respiratory tract were analyzed to understand the types and distribution of bacteria in the lung infection. Univariate statistical analysis was used to analyze the relationship between the patient′s clinical outcome with age, diabetes, hypertension, renal insufficiency, hypoproteinemia, anemia, chronic respiratory disease, surgery, tracheotomy, and bacterial multi-resistance. Binary logistic regression analysis was used to analyze the influencing factors of death in NICU patients with pulmonary infection.Results:A total of 112 pathogenic bacteria were isolated in this research group, including 83 Gram-negative bacteria (74.11%), 22 Gram-positive bacteria (19.64%), and 7 Fungi (5.25%). Imipenem was highly sensitive to Gram-negative bacteria, vancomycin was highly sensitive to Gram-positive bacteria, and other drugs were highly resistant. 41 patients died (47.13%). Age≥60 ( OR=3.501, 95% CI: 1.152-10.638), renal insufficiency ( OR=3.872, 95% CI: 1.336-11.224), tracheotomy ( OR=0.317, 95% CI: 0.114-0.882), bacteria multi-drug resistance ( OR=3.480, 95% CI: 1.162-10.422) were independent risk factors for death in NICU patients with pulmonary infection. Conclusions:Patients with severe neurological diseases are in critical condition, and there are many patients with pulmonary infection, with poor prognosis and high mortality. Gram-negative bacteria are the most common respiratory pathogens. Carbapenems account for the highest proportion of antibiotics in clinic. Advanced age, renal insufficiency and bacterial multidrug resistance increase the mortality of patients, while early tracheotomy can reduce the mortality of patients.
