中心静脉导管病原菌污染调查

目的探讨中心静脉导管（CVC）的病原学特征。方法回顾分析近5年临床各科送检的CVC病原学结果及细菌耐药性。结果3189份CVC标本中471份（14.77%）检出致病菌514株,G＋球菌、G-杆菌和真菌分别占42.41%、40.66%和16.93%;最常见的致病菌分别为表皮葡萄球菌（15.56%）、金黄色葡萄球菌（13.81%）、铜绿假单胞菌（13.23%）、肺炎克雷伯菌（7.59%）和鲍氏不动杆菌（6.23%）;91.18%为耐甲氧西林金黄色葡萄球菌（MRSA）,88.57%为耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）,12.00%肠杆菌科产超广谱β-内酰胺酶（ESBLs）;44.12%铜绿假单胞菌和34.38%鲍氏不动杆菌全部耐药。结论CVC检出病原菌以耐药菌为主,应加强病原学监测及导管护理,是控制导管相关性感染的关键。

Pathogens on Central Venous Catheter Tips:An Investigation

OBJECTIVE To investigate the characteristic of pathogens of central venous catheter(CVC).METHODS The pathogens of CVC from different departments and their drug-resistances were analyzed retrospectively in recent 5 years.RESULTS Totally 471(14.77%) of 3 189 samples were isolated with 514 strains of microorganisms,of which G+ bacteria accounted for 42.41%,G-bacteria 40.66%,and yeasts 16.93%.The most common pathogens were Staphylococcus epidermidis(15.56%),S.aureus(13.81%),Pseudomonas aeruginosa(13.23%),Klebsiella pneumoniae(7.59%) and Acinetobacter baumannii(6.23%),respectively.91.18% of S.aureus were MRSA,88.57% of S.epidermidis were MRCNS and 12% of Enterobacter were ESBLs.44.12% of P.areuginosa and 34.38% of A.baumannii were pan-drug resistant.CONCLUSIONS The most commonly encountered pathogens of CVC are almost drug-resistant,the organism monitoring and the medical attendance of catheters should be enforced.