Analysis Of Risk Factors For Nosocomial Infection In Patients With Intracranial Tumor Surgery

Objective: To investigate the incidence of nosocomial infection after craniotomy in patients with intracranial tumor,and explore the risk factors and prevention measures of nosocomial infection in patients undergoing craniotomy in our hospital.Method: On the basis of referring to domestic and foreign literature,we studied 288 cases of patients with intracranial tumor in Guangxi Medical University AffiliatedTumor Hospital from January 2014 to June 2016.The clinical data included the incidence of nosocomial infection,the site of infection,the distribution of pathogens and the risk factors of nosocomial infection which were retrospectively reviewed and analyzed by univariate and multivariate Logistic regression analysis.Result:1,A total of 288 cases of patients with intracranial tumor surgery had been investigated from January 2014 to June 2016,including 136 cases of male patients(47.22%)and 152 cases of female patients(52.78%)with average age with 45.70±15.49 years old.The minimum age of the patients was 6 years old,the maximum age was 81 years.2,There were 41 cases of patients suffered from nosocomial infection among 288 cases of patients,and the infection rate was 14.24%.The distribution of susceptible sites were: 27 cases of pulmonary infection(9.38%),intracranial infection in 7 cases(2.43%),urinary tract infection in 3 cases(1.04%),blood infection in 2 cases(0.69%),incision infection in 2 cases(0.69%).3,There were 17 strains of pathogenic bacteria decteted from the 41 cases of nosocomial infectioned patients with sputum,cerebrospinal fluid,wound secretions,blood,and urine.7 strains of Gram negative bacteria had been isolated which accounting for 41.18% among these pathogenic bacteria;5 strains of Gram positive bacteria and 5 strains of fungi had been isolated,which accounting for 29.41% respectively.the first rank was Candida albicans,followed by Staphylococcus aureus,Pseudomonas aeruginosa,ESBL producing Escherichia coli.4,Univariate analysis showed that the incidence of nosocomial infection in patients with intracranial tumor after operation was related to the operation site,operation time,indwelling drainage tube,blood transfusion,operation frequency,postoperative GCS score(P<0.05).However,there were no significant differences in gender,age,preoperative blood glucose,postoperative albumin,postoperative glucocorticoid use,and surgical season(P〉0.05).Surgical site,operation time,indwelling drainage tube,blood transfusion,operation time,postoperative GCS score were risk factors for postoperative nosocomial infection in patients with intracranial tumors.Multivariate logistic regression analysis indicated that subtentorial sugery,the time of indwelling drainage tube was more than 2 days,blood transfusion,multiple operations,and low GCS score were independent risk factors for nosocomial infection after craniotomy.Conclusion:1,The incidence of nosocomial infection was relatively high in patients with intracranial tumors,and the main infection site was lung.2,The occurrence of nosocomial infection in patients with intracranial tumor surgery was associated with multiple factors,such as,infratentorial removal of intracranial tumors,intraoperative blood transfusion,drainage time more than 2 days,multiple operations,and low Glasgow Coma Score(GCS)in the postoperative period.