血液透析中心静脉导管相关性感染危险因素及病原学临床分析

目的研究血液透析导管相关性感染的危险因素及病原学。方法对89例导管相关性感染的患者性别、年龄、白细胞计数、血浆白蛋白、血红蛋白、血肌酐、基础疾病、插管次数、插管部位、留置时间及病原学进行分析。结果 CRI与留置时间、留置部位、插管次数、合并糖尿病等因素有关(P<0.05),与患者性别、年龄、白细胞计数、血浆白蛋白、血红蛋白、血肌酐无相关性(P>0.05)。76例标本细菌培养阳性。共分离出12种病原菌,革兰氏阳性球菌49株,革兰氏阴性杆菌27株。表皮葡萄球菌占24.21%,鲍曼不动杆菌占17.46%,金黄色葡萄球菌占15.91%。结论长时间放置导管、反复插管、插管的不同部位及糖尿病是CRI的相关危险因素。CRI的主要致病菌为表皮葡萄球菌、鲍曼不动杆菌、金黄色葡萄球菌。

Risk Factors and Clinical Etiological Analysis of Catheter - related Infections in Hemodialysis

Objective To explore the risk factors of catheter- related infections （CRI） in hemodialysis and to make etiological study. Methods An analysis was made to the clinical data of 89 cases with CRI, including their sex, age, white blood cell count, plasma albumin, hemoglobin, serum creatinine, basic diseases, number of intubation times, intubation site, and indwelling time length; etiological study was made. Results CR1 was related to indwelling time length, intubation site, the number of intubation times and the combination with diabetes （P 〈 0. 05 ） while was in no relation to sex, age, white blood cell count, plasma albumin, hemoglobin and serum creatinine （P 〉 0. 05 ） ; bacterial culture of 76 samples turned out to be positive, and 12 kinds of pathogenic bacteria were isolated： 49 strains of Gram - positive cocci and 27 strains of Gram -negative bacilli; Staphylococcus epidermidis took up 24. 21%, Acinetobacter baumannii took up 17.46% and Staphylococcus aureus took up 15. 911%. Conclusions Long indwelling time length, repeated intubation, different sites of intubation and combination of diabetes are the related risk factors of CRI ; Staphy- lococcus epidermidis, Acinetobacter baumannii and Staphylococcus aureus are the main pathogenic bacteria of CRI.