中心静脉导管相关性感染菌血症病原菌研究

目的:探讨中心静脉留置导管患者导管相关性感染(CR I)菌血症病原菌的细菌学情况。方法:对我院综合性重症监护病房(GICU)内,近五年发生的CR I菌血症患者的静脉血、体内导管的尖端、中间段和皮下段各1cm长,及穿刺点部位皮肤分泌物,分别作细菌培养加药敏和定量分析的结果,作回顾分析。结果:采集标本105份,31份细菌培养结果阳性,检出病原菌38株,G 菌以金黄色葡萄球菌为主,占57.89%(22/38);G-菌以绿脓杆菌为主,占36.84%(14/38),所检出菌株数与导管留置时间呈正相关,且具有多耐药性和较高耐药率。结论:CR I菌血症属医院内感染的一种,由其主要病原菌的特点,给经验性使用抗菌药物提供了参考依据。植管术中严格消毒、无菌操作及术后规范护理是预防的关键措施,拔除导管和以导管尖端为主的多种标本细菌学检查结果为依据的目标治疗,为主要治疗措施。

Study of Centric Venous Catheter Relative Infection Bacterium

Objective: To study on pathogenic bacterium's bacteriological status of catheter relative infection(CRI) bacteremia in patients indwelled centric venous catheter.Method: Chose CRI bacteremia patients who had bacteriological gists in the synthetic intensive care unit(GICU) of our hospital in recent 5 years,gathered their venous blood,1 centimeter's segments of the tip,mid and hypodemic catheters inside them,cutaneous secretion of punctured position,made out these samples' germiculture,drug sensitivity and quantitative analysis.Result: 105 samples were collected,31 revealed positive of germiculture,38 pathogenic bacterium were cultivated,G~ bacterium were primarily golden staphylococcus,taking 57.89%(22/38);G~-bacterium primarily bacillus aeruginosus,taking 36.84%(14/38).The quantity of those bacterium cultivated had positive relationship with the time of indwelling catheter,and those bacterium had multidrug-fast and higher drug-fast rate.Conclusion: CRI bacteremia was one of hospital acquired infections.The characteristic of the primary bacterium offered referenced gists to the medication by experiences.Disinfecting strictly when indwelling catheters,axenic operation and nursing normatively after the operations were the key preventive measures.Removing the catheters,eliminating bacterial invasive approach and aiming treatments according to the results of multi-sample germiculture and drug sensitivity were the primary therapies of CRI bacteremia.