中华心律失常学杂志
中華心律失常學雜誌
중화심률실상학잡지
CHINESE JOURNAL OF CARDIAC ARRHYTHMIAS
2013年
6期
422-426
,共5页
刘俊鹏%杨杰孚%佟佳宾%邹彤%陈柯萍%戴研%刘志敏
劉俊鵬%楊傑孚%佟佳賓%鄒彤%陳柯萍%戴研%劉誌敏
류준붕%양걸부%동가빈%추동%진가평%대연%류지민
心血管植入型电子器械%感染%危险因素
心血管植入型電子器械%感染%危險因素
심혈관식입형전자기계%감염%위험인소
Cardiac implantable electronic device%Infection%Risk factor
目的 研究心血管植入型电子器械(cardiac implantable electronic device,CIED)更换患者囊袋的无症状感染发生率及相关危险因素.方法 连续入选2011年1月至2012年3月在卫生部北京医院及阜外心血管病医院行CIED更换术并除外临床诊断囊袋感染或起搏导线相关感染性心内膜炎患者127例,分别进行血培养和囊袋组织培养,并收集相关临床特征及检查指标,进行单因素及多因素回归分析.结果 127例行CIED更换的患者,血培养均为阴性,囊袋组织培养阳性率为15.8％,最主要的致病菌为凝固酶阴性葡萄球菌(14例,70％).单因素分析发现男性、恶性疾病、应用抗血小板药物、更换频次有统计学意义.多因素Logistic回归分析发现更换频次、既往抗生素使用、抗血小板药物使用为无症状囊袋感染的独立危险因素.结论 临床上无任何感染表现的CIED植入患者中,隐匿性囊袋感染发生率为15.8％,其独立的危险因素是更换频次、既往抗生素使用、抗血小板药物使用.
目的 研究心血管植入型電子器械(cardiac implantable electronic device,CIED)更換患者囊袋的無癥狀感染髮生率及相關危險因素.方法 連續入選2011年1月至2012年3月在衛生部北京醫院及阜外心血管病醫院行CIED更換術併除外臨床診斷囊袋感染或起搏導線相關感染性心內膜炎患者127例,分彆進行血培養和囊袋組織培養,併收集相關臨床特徵及檢查指標,進行單因素及多因素迴歸分析.結果 127例行CIED更換的患者,血培養均為陰性,囊袋組織培養暘性率為15.8％,最主要的緻病菌為凝固酶陰性葡萄毬菌(14例,70％).單因素分析髮現男性、噁性疾病、應用抗血小闆藥物、更換頻次有統計學意義.多因素Logistic迴歸分析髮現更換頻次、既往抗生素使用、抗血小闆藥物使用為無癥狀囊袋感染的獨立危險因素.結論 臨床上無任何感染錶現的CIED植入患者中,隱匿性囊袋感染髮生率為15.8％,其獨立的危險因素是更換頻次、既往抗生素使用、抗血小闆藥物使用.
목적 연구심혈관식입형전자기계(cardiac implantable electronic device,CIED)경환환자낭대적무증상감염발생솔급상관위험인소.방법 련속입선2011년1월지2012년3월재위생부북경의원급부외심혈관병의원행CIED경환술병제외림상진단낭대감염혹기박도선상관감염성심내막염환자127례,분별진행혈배양화낭대조직배양,병수집상관림상특정급검사지표,진행단인소급다인소회귀분석.결과 127례행CIED경환적환자,혈배양균위음성,낭대조직배양양성솔위15.8％,최주요적치병균위응고매음성포도구균(14례,70％).단인소분석발현남성、악성질병、응용항혈소판약물、경환빈차유통계학의의.다인소Logistic회귀분석발현경환빈차、기왕항생소사용、항혈소판약물사용위무증상낭대감염적독립위험인소.결론 림상상무임하감염표현적CIED식입환자중,은닉성낭대감염발생솔위15.8％,기독립적위험인소시경환빈차、기왕항생소사용、항혈소판약물사용.
Objective To evaluate the prevalence of bacterial colonization of generator pockets in cardiac implantable electronic device (CIED) patients without signs of infection and to analyse risk factors.Methods In 127 CIED patients undergoing generator replacement between January 2011 and march 2012 in Beijing Hospital and Fuwai Hospital,microbiological cultures of blood and generator pockets were consecutively obtained.Patients with clinical evidence of CIED infection were excluded.Univariate and multivariable analyses were performed to identify significant risk factors for positive cultures from the generator pockets.Results Positive cultures from the generator pockets were found in 20 patients(15.8％).The most common bacteria isolated were coagulase negative staphylococci(70％).A multivariable logistic regression model identified the times of replacement,previous antibiotic and long-term antiplatelet therapy as independent risk factors for asymptomatic bacterial colonization of generator pockets.Conclusion 15.8％ of CIED patients undergoing generator replacement have an asymptomatic bacterial bacterial colonization of generator pockets.More attentions should be paid to the risk factors.
