CAJ | 학술논문

目的探讨急诊重病监护病房(emergency intensive care unit,EICU)住院患者中心静脉导管相关性感染(catheter related infection,CRI)的病原学特征以及相关危险因素.方法对2008年1月至2010年12月收住于福建省立医院EICU内置入中心静脉导管的1363例患者进行回顾性研究,采用x2线性趋势检验及多因素非条件Logistic回归分析,观察、统计和分析其CRI发生率、病原学特征以及可能相关危险因素.结果共收集中心静脉留置导管1363根,导管检出病原菌阳性为147例,CRI发生率为10.79％,每1000导管日发生CRI 3.05次；CRI主要病原菌依次为革兰阴性杆菌(46.94％)、革兰阳性球菌(40.14％)、真菌(12.92％).多因素非条件Logistic回归分析提示,年龄、重复置管、股静脉置管、使用多腔导管、长期留置导管、病情危重和长期使用抗菌药物为CRI独立危险因素.结论应加强CRI危险因素控制,预防医院感染的发生.
목적 탐토급진중병감호병방(emergency intensive care unit,EICU)주원환자중심정맥도관상관성감염(catheter related infection,CRI)적병원학특정이급상관위험인소.방법 대2008년1월지2010년12월수주우복건성립의원EICU내치입중심정맥도관적1363례환자진행회고성연구,채용x2선성추세검험급다인소비조건Logistic회귀분석,관찰、통계화분석기CRI발생솔、병원학특정이급가능상관위험인소.결과 공수집중심정맥류치도관1363근,도관검출병원균양성위147례,CRI발생솔위10.79％,매1000도관일발생CRI 3.05차；CRI주요병원균의차위혁란음성간균(46.94％)、혁란양성구균(40.14％)、진균(12.92％).다인소비조건Logistic회귀분석제시,년령、중복치관、고정맥치관、사용다강도관、장기류치도관、병정위중화장기사용항균약물위CRI독립위험인소.결론 응가강CRI위험인소공제,예방의원감염적발생.
Objective To investigate the characteristics of pathogens and risk factors of the catheterassociated infection (CAI) in emergency ICU (EICU) in order to design an appropriately therapeutic strategy for the future.Methods From January 2008 to December 2010,a total of 1363 patients were enrolled for this retrospective study.Blood sample taken from the vein with indwelling catheterization and the tips of catheters cut in 5 cm after withdrawn from the veins in 1363 patients were collected for bacterial culture.Results Of 1363 catheters,pathogens were found in 147 (10.79％) after venous catheterization.The daily occurrences of CAI were 3.05 ones per 1000 catheters.Of 147 cases of infection,46.94％ pathogens were gram-negative bacilli,40.14％ gram-positive cocci,and 12.92％ fungi.Unconditional Logistic regression analysis suggested that repeated catheterization,femoral vein catheterization,the application of multi-lumen catheter and long-term indwelling catheterization were the independent risk factors responsible for CAI.Conclusions The risk factors responsible for catheter related infections should be controlled to prevent the occurrence of nosocomial infection.