Pathogenic characteristics and risk factors of pulmonary infection in patients with craniocerebral injury after intracranial infection

doi:10.3877/cma.j.issn.2096-1537.2020.03.011

Abstract

Abstract:

Objective

To investigate the pathogenic characteristics and risk factors of pulmonary infection in patients with craniocerebral injury.

Methods

The clinical data of 89 patients with pulmonary infection after craniocerebral injury admitted to our hospital from November 2016 to October 2019 were included as study subjects (observation group), and 40 patients without pulmonary infection after craniocerebral injury in the same period were collected as a control group. The distribution of pathogenic bacteria in patients with pulmonary infection after craniocerebral injury was analyzed, and single-factor and multi-factor Logistic regression analyses were used to identify the risk factors of pulmonary infection in patients with craniocerebral injury.

Results

A total of 120 strains of pathogenic bacteria were detected in 89 patients with intracranial infection, of which 71 (59.17%) were Gram-positive, including 32 (26.67%) strains of Staphylococcus aureus and 23 (19.16%) strains of Staphylococcus epidermidis; 43 (35.83%) were Gram-negative, including 19 (15.83%) strains of Escherichia coli and 16 (13.33%) strains of Pseudomonas aeruginosa. A total of 112 strains of pathogenic bacteria were detected in 89 patients with pulmonary infection, of which 34 (30.36%) were Gram-positive, including 22 (19.64%) strains of Staphylococcus aureus; 78 (69.64%) were Gram-negative bacteria, including 36 (32.14%) strains of Acinetobacter baumannii. Single-factor analysis showed that age, open injury, multiple injury, tracheotomy, complications, shock, length of stay, and smoking history differed significantly between the two groups (P<0.05). Age>50 years, multiple injury, tracheotomy, number of complications>2, shock, and hospital stay>15 days were identified to be the independent risk factors for pulmonary infection in patients with intracranial infection (P<0.05).

Conclusion

Gram-negative bacterial infection is the main cause of pulmonary infection in patients with intracranial infection after craniocerebral injury. Many factors are associated with the risk of pulmonary infection in patients with intracranial infection after craniocerebral injury. Therefore, we should take corresponding preventive and therapeutic measures to reduce the probability of pulmonary infection and improve the prognosis.

Key words: Brain injury, Intracranial infection, Pulmonary infection, Pathogenic characteristics, Risk factors

Ning Liu, Shaohui Chao, Jieqiong Lin, Jianhui Jin, Rong Qin. Pathogenic characteristics and risk factors of pulmonary infection in patients with craniocerebral injury after intracranial infection[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2020, 06(03): 296-300.

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病原菌		株数（n=112）	构成比（%）
革兰阳性菌		34	30.36
	金黄色葡萄球菌	22	19.64
	溶血性葡萄球菌	12	10.71
革兰阴性菌		78	69.64
	鲍曼不动杆菌	36	32.14
	铜绿假单胞菌	13	11.61
	肺炎克雷伯菌	18	16.07
	大肠埃希菌	9	8.04
	阴沟肠杆菌	2	1.79

病原菌		株数（n=112）	构成比（%）
革兰阳性菌		34	30.36
	金黄色葡萄球菌	22	19.64
	溶血性葡萄球菌	12	10.71
革兰阴性菌		78	69.64
	鲍曼不动杆菌	36	32.14
	铜绿假单胞菌	13	11.61
	肺炎克雷伯菌	18	16.07
	大肠埃希菌	9	8.04
	阴沟肠杆菌	2	1.79

影响因素	观察组（n=89）	对照组（n=40）	χ²值	P值
男性	51（57.30）	23（57.50）	0.001	0.983
年龄>50岁	60（67.42）	14（35.00）	11.861	0.001
开放性损伤	56（62.92）	16（40.00）	5.879	0.015
多发损伤	58（65.17）	15（37.50）	8.610	0.003
使用抗菌药	61（68.54）	25（62.50）	0.453	0.501
气管切开	55（61.80）	11（27.50）	12.991	<0.001
合并症>2个	49（55.06）	10（25.00）	10.051	0.002
休克	48（53.93）	11（27.50）	7.769	0.005
住院时间>15 d	67（75.28）	15（37.50）	29.211	<0.001
有吸烟史	36（40.45）	7（17.50）	6.541	0.011
有酗酒史	27（30.34）	11（27.50）	0.107	0.744

影响因素	观察组（n=89）	对照组（n=40）	χ²值	P值
男性	51（57.30）	23（57.50）	0.001	0.983
年龄>50岁	60（67.42）	14（35.00）	11.861	0.001
开放性损伤	56（62.92）	16（40.00）	5.879	0.015
多发损伤	58（65.17）	15（37.50）	8.610	0.003
使用抗菌药	61（68.54）	25（62.50）	0.453	0.501
气管切开	55（61.80）	11（27.50）	12.991	<0.001
合并症>2个	49（55.06）	10（25.00）	10.051	0.002
休克	48（53.93）	11（27.50）	7.769	0.005
住院时间>15 d	67（75.28）	15（37.50）	29.211	<0.001
有吸烟史	36（40.45）	7（17.50）	6.541	0.011
有酗酒史	27（30.34）	11（27.50）	0.107	0.744

自变量	赋值方法
年龄	<50岁=1，50~60岁=2，>60岁=3
开放性损伤	是=1，否=0
多发损伤	是=1，否=0
气管切开	是=1，否=0
合并症（个）	2个=1，3个=2，≥4个=3
休克	是=1，否=0
住院时间（d）	<15 d=0，15~25 d=2，>25 d=3
有吸烟史	是=1，否=0

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