2009年北京大学第三医院血管内插管相关性感染的病原学分析

目的 了解2009年北京大学第三医院血管内插管相关性感染的特征.方法 回顾性分析血管内插管相关性感染的临床特征和微生物学特征.结果 共送检各类插管219个.通过插管培养法确定29例定植、7例置入点感染、6例插管相关性血流感染(CRBSI),但无阳性报警时间差方式确诊的CRBSI.ICU的CRBSI的发生率为(0.99～3.03)/千插管日.定植菌株中,革兰阳性球菌为51.72%,非发酵菌为20.69%,肠杆菌为13.79%,假丝酵母菌为10.34%.1例CRBSI由肠膜明串珠菌导致.细菌类分离株多为耐药菌株.成人患者77%以上超过60岁,多有长期慢性基础性疾病.而9例新生儿患者全部是早产儿,其中7例为极低出生体质量儿.结论 北京大学第三医院2009年有一定数量的插管相关性感染发生,需要进一步加强插管相关工作.

The pathogens of intravascular catheter-related infections in Peking University Third Hospital in 2009

Objective To investigate the characteristic of intravascular catheter-related infections (CRI) in Peking University Third Hospital in 2009. Methods The clinical and microbiological features of CRI were analyzed retrospectively. Results Two hundred and nineteen catheters were examined. Twenty-nine CRI cases were confirmed with colonization, 7 were insertion site infection and 6 were catheter-related bloodstream infections (CRBSI) by quantitative catheter culture method, but no CRBSI was diagnosed by differential time to positivity (DTTP) method. The incidence rates of CRBSI in intensive care units (ICU) were 0. 99- 3.03 per 1000 catheter-days.Among the colonized strains, 51.72 % were Gram-positive cocci, 20.69 % were non-fermenting bacilli (NFB), 13. 79% were Enterobacteriaceae and 10. 34% were Candida. One neonatal CRBSI was caused by Leuconostoc mesenteroides. Most of bacterial isolates were drug resistant. Seventy-seven percent of adult patients were older than 60 years and most of them had chronic underlying diseases.All of the 9 neonate patients were preterm neonate and 7 of them were extremely low birth weight infants. Conclusion There is a certain amount of CRI occurred in Peking University Third Hospital in 2009 and the intravascular catheter management should be enhanced.