Pathogen profiles and risk factors of hospital-acquired infections in traumatic brain injury patients

TL;DR

This study examines hospital-acquired infections in traumatic brain injury patients, identifying common pathogens and risk factors to improve prevention and treatment.

Contribution

The study provides new insights into infection risk factors and antimicrobial resistance patterns specific to traumatic brain injury patients.

Findings

Hospital-acquired infections occurred in 19.40% of traumatic brain injury patients.

Gram-negative bacteria like Klebsiella pneumoniae and Pseudomonas aeruginosa were the most common pathogens.

Risk factors included age ≥60, low GCS score, prolonged hospitalization, and urinary catheter use.

Abstract

Traumatic brain injury (TBI) represents a significant public health challenge, marked by elevated incidence rates and significant morbidity, frequently resulting in long-term disabilities and imposing substantial economic burdens on healthcare systems. This study seeks to examine the incidence of hospital-acquired infections (HAIs), characterize prevalent pathogens, evaluate antimicrobial susceptibility patterns, and identify risk factors associated with HAIs in TBI patients.

A retrospective analysis was performed on a cohort of 2,314 hospitalized TBI patients. Data were collected on demographic characteristics, clinical history, treatment modalities, and infection outcomes were systematically collected. The incidence proportion of HAIs in TBI patients was analyzed, key pathogens and their antimicrobial resistance patterns were identified. Univariate and multivariate logistic regression analyses were performed to assess risk factors for HAIs of TBI patients.

Among 2,314 hospitalized TBI patients, the incidence of HAIs was 19.40%. The most frequent infection sites were the lower respiratory tract (14.87%) and urinary tract (6.66%), whereas gentral nervous system infections were infrequent (0.39%). A total of 555 distinct pathogens were first-isolated, with Gram-negative bacteria representing the majority (66.85%), particularly Klebsiella pneumoniae (14.59%) and Pseudomonas aeruginosa (11.17%). Significant antimicrobial resistance was observed, including 100% resistance of Klebsiella pneumoniae to ampicillin and 95.83% resistance of Acinetobacter baumannii to ceftazidime. Univariate and multivariate logistic regression analyses revealed several independent risk factors for HAIs in TBI patients, including age ≥60 years, Glasgow Coma Scale (GCS) score ≤8, hospitalization duration exceeding 2 weeks, and the presence of urinary catheters.

This study highlights the necessity of risk factor identification for HAIs to facilitate risk stratification and the implementation of targeted preventive measures in the clinical management of TBI patients. Furthermore, sustained microbial surveillance is imperative to guide antibiotic stewardship and enhance diagnostic and therapeutic strategies for this patient population.