乳胶与全硅橡胶导尿管引起导管相关感染的研究

目的探讨不同材料导尿管留置导尿，医院泌尿系感染情况，以指导临床选择导尿管，并采取积极有效预防感染的措施。方法对60例需要留置导尿病人随机分为全硅橡胶及硅化乳胶导尿管两组，分别对尿道口周围皮肤、中段尿、拔管后导尿管尖端进行细菌培养。结果对照组与实验组均随插管时间延长，菌尿发生率增高，两组菌尿发生率差异无显著意义；拔管后导尿管尖端细菌培养的阳性率，对照组为36．67％，实验组为40％，两组差异无显著意义。尿道口周围皮肤、中段尿和拔管后导尿管尖端细菌培养的细菌种类分布相似，细菌培养病原菌种类依次排列为：表皮葡萄球菌、大肠埃希菌、白色念珠菌、粪肠球菌、克雷伯菌、不动杆菌、假单胞菌属、咽链球菌等。结论两类导管均不能减少导管相关感染的发生以及细菌生物膜的形成。结论是否发生导管相关感染与导管材料性质无关，导尿管腔外逆行感染是细菌侵入尿路的主要感染方式。

Clinical study on catheter associated infections caused by Urinary catheters made of different material

Objective To study the situation of urethral catheter associated urinary tract infection(CAUTI), to guide the clinical selection of urethral catheter and to take action for positive prevention the infection. Methods A random prospective clinical controlled trial for 60 patients (30 cases using absolute Silicone Catheter in study group and others 30 cases using common latex Catheter in control group ). Results There is no significant difference in urethral catheter tips culture Positive incidence and Urinary tract infections incidence, between the study and the control group. There is no significant difference in positive rate of bacterial culture of urethral catheter tip between the two group, the positive rate are 36. 6% and 40% for contrl group and study group. It have demonstrated that urine bacterial culture contained strains are as following in order: S epidermidis; Escherichiacoli; Candida spp, Enterococcus faecalis, Klebsiella and Pseudomonas aeruginosan. Conclusion It's suggest that urinary catheter infection is not concerning with material of urinary catheters, Reversed infection of inserted urinary Catheter may be the major cause acquire bacterial colonization.