中华医院感染学杂志
中華醫院感染學雜誌
중화의원감염학잡지
Chinese Journal of Nosocomiology
2015年
9期
2028-2029,2032
,共3页
血液透析%导管相关性血流感染%病原菌
血液透析%導管相關性血流感染%病原菌
혈액투석%도관상관성혈류감염%병원균
Hemodialysis%Catheter-associated bloodstream infection%Pathogen
目的：探讨血液透析患者导管相关性血流感染的病原菌分布及相关危险因素，为制定相应的干预措施提供参考依据。方法回顾性分析286例行中心静脉留置透析导管透析患者的临床资料，记录透析患者的年龄、性别、基础疾病、置管种类及部位、导管留置时间、病原菌培养结果。结果286例留置中心静脉透析导管患者，发生CRBSI 28例，发生率为9．79％；共分离出病原菌28株，其中革兰阳性菌20株占71．44％，以表皮葡萄球菌、金黄色葡萄球菌为主，革兰阴性菌8株占28．56％，以铜绿假单胞菌、大肠埃希菌、褪色沙雷菌为主；年龄＞60岁、原发病为糖尿病肾病、导管留置时间＞2周、行股静脉置管与CRBSI的发生具有相关性（P＜0．05）。结论 CRB‐SI感染病原菌以革兰阳性菌为主，高龄、糖尿病、导管留置时间长、股静脉置管为导管相关性血流感染的危险因素。
目的：探討血液透析患者導管相關性血流感染的病原菌分佈及相關危險因素，為製定相應的榦預措施提供參攷依據。方法迴顧性分析286例行中心靜脈留置透析導管透析患者的臨床資料，記錄透析患者的年齡、性彆、基礎疾病、置管種類及部位、導管留置時間、病原菌培養結果。結果286例留置中心靜脈透析導管患者，髮生CRBSI 28例，髮生率為9．79％；共分離齣病原菌28株，其中革蘭暘性菌20株佔71．44％，以錶皮葡萄毬菌、金黃色葡萄毬菌為主，革蘭陰性菌8株佔28．56％，以銅綠假單胞菌、大腸埃希菌、褪色沙雷菌為主；年齡＞60歲、原髮病為糖尿病腎病、導管留置時間＞2週、行股靜脈置管與CRBSI的髮生具有相關性（P＜0．05）。結論 CRB‐SI感染病原菌以革蘭暘性菌為主，高齡、糖尿病、導管留置時間長、股靜脈置管為導管相關性血流感染的危險因素。
목적：탐토혈액투석환자도관상관성혈류감염적병원균분포급상관위험인소，위제정상응적간예조시제공삼고의거。방법회고성분석286례행중심정맥류치투석도관투석환자적림상자료，기록투석환자적년령、성별、기출질병、치관충류급부위、도관류치시간、병원균배양결과。결과286례류치중심정맥투석도관환자，발생CRBSI 28례，발생솔위9．79％；공분리출병원균28주，기중혁란양성균20주점71．44％，이표피포도구균、금황색포도구균위주，혁란음성균8주점28．56％，이동록가단포균、대장애희균、퇴색사뢰균위주；년령＞60세、원발병위당뇨병신병、도관류치시간＞2주、행고정맥치관여CRBSI적발생구유상관성（P＜0．05）。결론 CRB‐SI감염병원균이혁란양성균위주，고령、당뇨병、도관류치시간장、고정맥치관위도관상관성혈류감염적위험인소。
OBJECTIVE To explore the distribution of pathogens causing catheter‐associated bloodstream infections in the hemodialysis patients and analyze the related risk factors so as to put forward targeted interventions . METHODS The clinical data of 286 patients who underwent indwelling central venous catheter hemodialysis were retrospectively analyzed;the age ,genders ,underlying diseases ,types of indwelling catheter ,intubation sites , catheter indwelling time ,and result of cultures of pathogens were recorded and observed .RESULTS The catheter‐associated bloodstream infections occurred in 28 of 286 patients undergoing indwelling central venous catheter he‐modialysis ,with the incidence rate of 9 .79% .A total of 28 strains of pathogens have been isolated ,including 20 (71 .44% ) strains of gram‐positive bacteria and 8 (28 .56% ) strains of gram‐negative bacteria;the Staphylococcus epidermidis and Staphylococcus aureus were the predominant species of the gram‐positive bacteria;the Pseudo‐monas aeruginosa ,Escherichia coli ,and Serratia marcescens were dominant among the gram‐negative bacteria . The prevalence of the catheter‐associated bloodstream infections was associated with more than 60 years of age , primary disease of diabetic nephropathy ,catheter indwelling time more than 2 weeks ,and femoral venous cathe‐terization .CONCLUSION The gram‐positive bacteria are dominant among the pathogens causing the catheter‐asso‐ciated bloodstream infections .The risk factors for the catheter‐associated bloodstream infections include the ad‐vanced age ,diabetic mellitus ,long catheter indwelling time ,and femoral venous catheterization .
