Analysis Of Risk Factors Of Multidrug-Resistant Organism Bacterial Infection In Postoperative Patients With Type A Aortic Dissection

ObjectiveThis paper collects the operation cases of type A aortic dissection conducted in our hospital and summarizes relevant risk factors of multidrug-resistant organism infection in order to provide scientific basis for its clinical prevention and cure.MethodsThe data of clinical history for 88 postoperative patients with type A aortic dissection is reviewed in retrospective study.They are divided into group A(multidrug-resistant organism infection group,23 cases)and group B(non-multidrug-resistant organism infection group,65 cases)according to the fact whether they have acquired multidrug-resistant bacterial infection on the basis of the diagnostic criteria of multidrug-resistant bacterial infection.Relevant clinical data is explored,19 Preoperative factors are collected including age,sex,diabetes,high blood pressure and so on.Eight intraoperative factors are collected including emergency operation,duration of operation,CPB time,operation method and so on.Postoperative factors include blood transfusion volume,plasma transfusion volume,platelet transfusion volume,multiple intubation,auxiliary ventilation time,indwelling time of catheter,nasogastric tube indwelling time,continuous renal replacement therapy,gastrointestinal complication,renal inadequacy,hepatic insufficiency,ICU stay,postoperative use of carbapenem antibiotics and so on.Single-factor analysis is used to screen out statistically significant risk factors and Binary Logistic regression analysis is further applied to determine the independent risk factors for multidrug-resistant bacterial infection in postoperative patients with type A aortic dissection.Results1.The single factor analysis shows that 12 factors are independent risk factors for multidrug-resistant organism infection in postoperative patients with type A Stanford aortic dissection,which include age,plasma transfusion volume,platelet transfusion volume,renal insufficiency,ICU stay time,nasogastric tube indwelling time,auxiliary ventilation time,multiple endotracheal intubation,tracheotomy,continuous renal replacement therapy,application of over 3 varieties of antibiotics,utility time of antibiotics.2.Multiple factor analysis demonstrates that various factors are deemed as independent risk factors for multidrug-resistant organism infection in postoperative patients with type A aortic dissection such as plasma transfusion volume,auxiliary ventilation time and application of over 3 varieties of antibiotics.3.Among those pathogen,Baumanii takes the largest proportion(53.85% of total person-time),and klebsiella pneumonia shares the second-largest proportion(34.62% of total person-time).Among those specimens,sputamentum takes the largest proportion.Conclusion1.Several factors are considered as potential risk factors for multidrug-resistant bacterial infection,including plasma transfusion volume,auxiliary ventilation time and application of over 3 varieties of antibiotics,consequently,rational grasp of the auxiliary ventilation time,the use of antibiotics as well as plasma transfusion volume are likely to reduce the percentage for multidrug-resistant bacterial infection in postoperative patients with type A Stanford aortic dissection.2.Among those pathogen,Baumanii takes the largest proportion,and klebsiella pneumonia shares the second-largest proportion.Lung is the most commonly infected organs.