Risk Factors for Infections Related to Lumbar Drainage in Spontaneous Subarachnoid Hemorrhage
Risk Factors for Infections Related to Lumbar Drainage in Spontaneous Subarachnoid Hemorrhage
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自发性蛛网膜下腔出血腰椎引流相关感染的危险因素
DOI：
10.1007/s12028-015-0239-1
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发表时间：
2016-10-01
影响因子：
3.5
通讯作者：
Zhang, Xiangtong
中科院分区：
文献类型：
--
作者：
Liang, Hongsheng;Zhang, Liyang;Zhang, Xiangtong
背景对自发性蛛网膜下腔出血（SAH）患者腰椎引流（LD）相关感染的充分认识是必要的，这将有助于采取有效措施科普这一并发症。我们的目的是描述发病率和危险因素与LD相关的感染SAHpatients.MethodsA回顾性分析SAH患者谁接受LD在2010年7月至2015年8月。审查患者病历，以检索人口统计学、临床和实验室数据。根据脑脊液培养结果结合临床症状确定LD相关感染。感染率进行了计算，并建立了Logistic回归模型，以确定危险factors.ResultsA共629例SAH患者（25-82岁的年龄范围，42.8%的男性）与LD治疗的时期。在36例患者（5.7%）中确定了LD相关感染。LD持续时间较长（≥4天：p= 0.0037）和穿刺部位渗漏（p< 0.0001）似乎是感染的风险因素。感染率随着住院时间的延长而增加（16-20天：p= 0.0032; ≥21天：p= 0.0007）。84.6革兰阳性菌占%，最常见的致病菌为耐甲氧西林凝固酶阴性葡萄球菌（MRCNS，61.5%）。受感染的病人更有可能在医院呆得更久。MRCNS被确定为最常见的致病病原体。在LD期间使用抗生素似乎并没有降低感染的风险。
BackgroundA solid knowledge associated with lumbar drainage (LD)-related infections in spontaneous subarachnoid hemorrhage (SAH) patients is necessary and that would be useful in taking effective measures to cope with this complication. We aimed to describe incidence rates and risk factors associated with LD-related infections in SAH patients.MethodsA retrospective review was performed on SAH patients who underwent LD between July 2010 and August 2015. Patient charts were reviewed to retrieve demographic, clinical, and laboratory data. LD-related infections were defined based on culture results of cerebrospinal fluid in combination with clinical symptoms. Infection rates were calculated, and a logistic regression model was developed to identify risk factors.ResultsA total of 629 SAH patients (25–82 years age range, 42.8 % male) were treated with LD in the period. LD-related infections were identified in 36 patients (5.7 %). Longer duration of LD (≥4 days:p= 0.0037) and puncture site leakage (p< 0.0001) appeared to be risk factors for infection. The infection rate increased with length of the hospital stay (16–20 days:p= 0.0032; ≥21 days:p= 0.0007). 84.6 % of the isolated bacteria were Gram-positive, and the most commonly associated pathogens were Methicillin-resistant coagulase-negativeStaphylococcus(MRCNS, 61.5 %).ConclusionsThe patients with LD for more than 4 days or with puncture site leakage had more risk of infection. Infected patients were more likely to stay longer in the hospital. MRCNS were identified as the most frequent causal pathogens. And the use of antibiotics during LD did not appear to reduce the risk of infection.