Analysis Of Risk Factors For Multi-drug Resistant Bacterial Infection In Patients Of Severe Neurologic Complicated With Pneumonia

Objective:objective to observe the pathogenic bacteria of MDRO infection in severe neurological patients with pneumonia,and to analyze the risk factors of MDRO infection.Methods:clinical data of 159 patients with severe neurological pneumonia were retrospectively collected and divided into case group(MDRO infection)and control group(non-mdro infection)according to the occurrence of MDRO infection.Results:A total of 174 strains of pathogenic bacteria were isolated from 159 patients,including 103 MDRO(59.2%)and 71 non-mdro(40.8%).Among the 135gram-negative bacteria(77.6%),43 were acinetobacter baumannii(24.7%),39 were klebsiella pneumoniae(22.4%)and 28 were pseudomonas aeruginosa(16.1%).Among the gram-positive bacteria(19.0%),there were 24 strains of staphylococcus aureus(13.8%).The MDRO composition ratio was from high to low,followed by 37 strains of acinetobacter baumannii(35.9%),klebsiella pneumoniae(18.4%),pseudomonas aeruginosa(16.5%),and staphylococcus aureus(15.5%).The results of single-factor analysis showed that nine factors,including time of stay in the NICU,number of days of antibiotics,type of antibiotics,combination of antibiotics,antimicrobial strategy,use of glucocorticoids,type of pneumonia,endotracheal intubation and Ventilator-associated pneumonia(VAP),were statistically significant for the occurrence of MDRO infection(P < 0.05).Multivariate logistic regression analysis showed that antimicrobial strategy(OR: 4.824,95%ci: 1.439 ~ 16.169,P=0.011),combination of antimicrobial agents(OR=4.615,95%ci :1.338 ~ 15.922,P=0.016)and endotracheal intubation(OR: 2.627,95%ci: 1.166 ~ 5.918,P=0.020)were risk factors for MDRO infection in patients with neurosurgical pneumonia.Conclusion:Results Conclusion active prevention,control and intervention measures should be taken to reduce the incidence of nosocomial infection with multidrug-resistant bacteria and improve the cure rate of patients with high risk of severe neurological infection with MDRO pneumonia.