Abstract: 【Abstract】〓Objective〓To investigate the incidence and risk factors of vancomycin-resistant enterococcus(VRE)colonization in neurosurgical intensive care unit (NICU). Methods〓From September 2010 to September 2013,this retrospective study was associated with cerebrovascular disease, brain trauma, brain tumor, spinal diseases in NICU. 414 patients were enrolled in the study, demographic characteristics and risk factors were collected for statistical analysis. Results〓Among 414 patients, 52 patients were infected with VRE, 362 patients were not infected with VRE. The third generation cephalosporins was the most used antibiotics accounting for 40.4% before VRE infection. The fourth generation cephalosporins was the least used antibiotics accounting for 5.8% before the VRE infection. The univariate analysis showed that women, GCS score<8, accompanied by symptoms of diabetes, indwelling tube>4, mechanical ventilation>2 weeks, ICU time>2 weeks, nearby VRE (+) patients (P<0.05) were risk factors for VRE infection. The Logistic regression analysis showed that GCS score<8, diabetes, catheterization>2 weeks, ICU time>2 weeks, nearby VRE (+) patients were independently associated with VRE infection (P<0.05). Conclusion〓When managing the high-risk patients being prone to be infected VRE in the NICU, extreme caution should be paid upon. The most crucial interventions are careful hand washing, strict glove handling, meticulous and active screening, and complete segregation.

Key words: Glasgow coma scale score, Neurosurgical intensive care unit, Vancomycin-resistant enterococcus, Segregation

摘要： 【摘要】〓目的〓本研究旨在明确万古霉素耐药性肠球菌感染(VRE)在神经外科重症监护病房(NICU)的发生率及危险因素。方法〓本回顾性研究纳入了从2010年9月至2013年9月,因重型颅脑损伤,急性出血性脑卒中,颅内肿瘤疾病收入NICU的患者。共有414例患者被纳入本研究,人口学特征及危险因素被采集后进行统计学分析。 结果〓在414例患者中,52例患者感染了VRE,362例患者未感染VRE。三代头孢在VRE感染前的使用最多,占40.4%,四代头孢在 VRE感染前的使用最少,为5.8%。VRE感染的单因素分析可见,女性,GCS评分<8,糖尿病伴随症,留置管>4,机械通气时间>2周,NSICU时间>2周,附近有VRE (+)患者均是VRE感染的危险因素(P<0.05)。VRE感染独立影响因素经Logistic回归分析后,GCS评分<8,伴随糖尿病,留置导尿>2周,NICU时间>2周,附近有VRE (+)患者与VRE感染独立相关(P<0.05)。结论〓对NSICU中VRE易感患者的处理需要极其小心,最重要的预防方法是医务人员洗手,严格带手套及严格的隔离可以预防VRE的感染。

关键词: 格拉斯哥昏迷量表评分, 神经外科重症监护病房, 万古霉素耐药性肠球菌感染, 隔离