Risk factors for multidrug-resistant gram-negative bacilli infection in patients with cerebral hemorrhage in the department of neurosurgery
10.12173/j.issn.1005-0698.202501048
- VernacularTitle:神经外科脑出血患者并发多重耐药革兰阴性杆菌感染的危险因素分析
- Author:
Kang YUAN
1
;
Maokun LI
1
Author Information
1. 长江大学附属第一医院神经外科(湖北 荆州 434000)
- Publication Type:Journal Article
- Keywords:
Cerebral haemorrhage;
Multidrug resistance;
Gram-negative bacilli;
Risk factors
- From:
Chinese Journal of Pharmacoepidemiology
2025;34(6):632-639
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore risk factors and construct a predictive model for multidrug-resistant gram-negative bacilli(MDR-GNB)infections in patients with cerebral hemorrhage.Methods A retrospective analysis was conducted on the clinical data of patients with cerebral hemorrhage complicated by gram-negative bacilli infections in the department of neurosurgery at the First Affiliated Hospital of Yangtze University from December 2020 to December 2023.Patients were divided into MDR-GNB group and non-MDR-GNB group based on the occurrence of MDR-GNB infections.General characteristics,underlying diseases,treatment methods,invasive procedures,and blood cell counts at admission were compared between the two groups.A multivariate Logistic regression analysis was used to determine the risk factors.Results A total of 308 patients with gram-negative bacilli infections were analyzed,including 143 in the MDR group and 165 in the non-MDR group.Theresults of the univariate analysis showed that impaired consciousness,use of meropenem,duration of antibiotics,duration of urinary catheter,duration of central venous catheter,duration of gastric tube,duration of tracheostomy,neutrophils at admission,and systemic immune-inflammation index(SII)at admission were significantly differentbetween the two groups(P<0.05).Theresults of the multivariate Logistic regression analysis showed that the use of meropenem,duration of antibiotics,higher neutrophils and SII levels at admission were the influencing factors for the MDR-GNB infections in patients with cerebral hemorrhage(P<0.05).Theresults of the receiver operating characteristic curve(ROC)analysis showed that the area under the curve(AUC)of the prediction model 1(constructed by neutrophils and duration of antibiotic use)and model 2(constructed by SII,meropenem use and duration of antibiotic use)for MDR-GNB infections were 0.678 and 0.690,respectively.Conclusions In addition to use of meropenem and a longer duration of antibiotic use,the neutrophil count and SII level at admission may both be associated with the development of MDR-GNB infections in patients with cerebral hemorrhage.
