85例中心静脉导管相关感染分析

目的：探讨心脏直视手术后与中心静脉导管相关感染的病原学和药敏以及预后。方法：利用Blot技术对500例成人心脏直视手术后的85例疑为中心静脉相关感染（CVCI）的患者进行诊断；冲洗导管的肉汤和外周血中培养出相同的菌株为确诊CVCI的诊断标准；同时进行病原学检查和药敏试验，并分析预后。结果：85例患者均确诊为CVCI，并分离出97株病 原菌，菌种绝大多数为表皮葡萄球菌和金黄色葡萄球菌，其次为阴沟杆菌和弗劳地枸椽酸菌；根据药敏试验合理使用抗生素，81人治愈，4人死于心力衰竭。结论：中心静脉导管相关感染的发生率较高，主要的致病菌为表皮葡萄球菌；这种细菌因产生抵抗吞噬细胞和抗生素的粘质而不易治疗，应根据药敏试验合理使用抗生素。

Central Venous Catheter Associated Infection from Open Heart Surgical Patients:Analysis of 85 Cases

OBJECTIVE To investigate the bacteria source and drug sensitivity of central venous catheter associated infection from open heart surgical patients postoperatively. The prognosis of the infection was observed. METHODS Eighty-four patients suspected central venous catheter associated infection (CVCI) from total 500 open heart surgical patients were included in the investigation. Blot technique was used to diagnose CVCI. The criterion of confirmed diagnosis of CVCI was that the same kind of bacteria was cultured from peripheral blood and washing bouillon of the catheter. The bacteria source and drug sensitive test were performed and the prognosis was analysed. RESULTS The eight-four patients were confirmed to be with CVCI, and ninety-seven strains were cultured. The most strains were Staphylococcus epidermidis and Micrococcus aureus, the other was Bacillus levans. Adequate antibiotics were used to cure CVCI according to drug sensitive test, and eight-one patients were cured but four were died of heart failure. CONCLUSIONS The incidence of central venous catheter associated infection is high after open heart surgery. The most common strain is S.epidermidis, which can excrete slime to resist phagocytosis of leucocytes and antibiotics. Therefore, it is important to use adequate antibiotics to cure CVCI according to drug sensitive test.