导管相关感染的病原学及相关危险因素

目的研究导管相关感染(catheter-related infections,CRI)的病原学及相关危险因素.方法对234例导管培养阳性病例,针对插管时间、拔管时间、插管部位、插管次数、临床表现、病原学及相关危险因素进行分析.结果66例患者确诊为CRI,其中真菌、表皮葡萄球菌、鲍氏不动杆菌在临床确诊病例中分别为22.7%、20.0%、16.7%;表皮葡萄球菌、粪肠球菌、酿脓链球菌在临床未确诊病例中分别为60.7%、14.3%、7.1%;与未确诊病例相比,CRI与患者的年龄、性别无关(P＞0.05),与导管留置时间、插管次数、插管部位有相关性(P＜0.05).结论CRI的主要病原菌为真菌、表皮葡萄球菌、鲍氏不动杆菌;长时间放置导管、反复插管及经颈内静脉置管可增加CRI的危险性.

Catheter-related Infections: Clinical Study about Pathogen and Relative Risk Factors

OBJECTIVE To study pathogens and relative risk factors of catheter-related infections(CRI). METHODS An analysis in 234 patients with positive results of catheter culture was made. Time of intubations, time of extubations, location of intravascular catheters, times of clinical findings and pathogens were analyzed. RESULTS Detectable rates of fungi, Staphylococcus epidermidis, and Acinetobacter were 22.7%,20.0%,and 16.7%, respectively in 66 diagnosed patients. Rates of S. epidermidis, Enterococcus faecium, Streptococcus pyogenes were 60.7%,14.3%,and 7.1% in non-diagnosed patients. CRI have no relation with age and sex of patients((P>0.05)),but they have relations with duration, times and location of catheters(P<0.05). CONCLUSIONS The major pathogens of CRI were fungi, S. epidermidis, and Acinetobacter. Long duration, more times of intubation and catheter placed in jugular vein can increase risks of infection.