重症监护室老年患者中心静脉导管相关血流感染的危险因素

目的探讨重症监护室（ICU）老年患者导管相关血流感染（CRBSI）的危险因素。方法ICU90例老年住院患者接受中心静脉置管，分为导管相关性血流感染（CRBSI）组和无感染（对照）组。CRBSI组患者为ICU住院的行深静脉置管伴CRBSI的病例（n=45），而对照组为同期ICU住院的行深静脉置管但无CRBSI的病例（17=45），采用回顾性和病例对照的研究方法，对两组患者进行风险困素分析。结果两组患者基础疾病构成、年龄、性别、感染前导管留鼍时间、机械通气、完全肠外营养、尿管留置等的差异无统计学意义（P〉0．05）。与对照组比较，CRBSI组使用碳青霉烯类抗生素、操作熟练程度、置管部位、低白蛋白血症、贫血、APACHEII评分差异有统计学意义（P〈0．01、P〈0．05）。使用碳青霉烯类抗生素、操作者、低A蛋白血症、APACHEII评分是CRBSI独立危险因素。结论碳青霉烯类抗生素使用、操作者人员熟练程度、低白蛋A血症及APACHEII评分是ICU老年患者CRBSI的独立危险因素。

Risk factors of central venous catheter-related bloodstream infections of the elderly patients in ICU

Objective To explore the risk factors of Central venous catheter-related bloodstream infections （CRBSI） in respiratory intensive care unit. Methods The elderly patients with central venous catheter-related bloodstream infection in ICU were screened to analyze （n=45）. Patients in the same period of hospitalization without catheter-related bloodstream infections were enrolled as control （n=45）. Results There were no significant differences （P〉0.05） of underlying disease, age, gender, catheter-days, mechanical ventilation, total parenteral nutrition and indwelling catheter between two groups. Carbapenem antibiotic use, proficiency of the operation, catheter implanting site, hypoalbuminemia, anemia and APACHEII score were significantly different between two groups （P〈0.01, P〈0.05）. Multiple logistic regression analysisshows that use of carbapenems, operator, hypoalbuminemia, APACHEII score were independent risk factors. Conclusions Use of carbapenems, operator, hypoalbuminemia, APACHEIl score were independent risk factors of central venous catheter-related bloodstream infections in respiratory ICU elderly patients.