| 中心静脉导管相关性血流感染的临床及病原学的回顾性调查分析 |
| 投稿时间：2016-09-26 修订日期：2016-10-16 点此下载全文 |
| 引用本文：陶真,林小玲,甘文思,杨坤,金细众.中心静脉导管相关性血流感染的临床及病原学的回顾性调查分析[J].医学研究杂志,2017,46(5):159-163 |
| DOI：
10.11969/j.issn.1673-548X.2017.05.039 |
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| 中文摘要:目的 了解重症监护室（ICU）中心静脉导管相关性血流感染（CRBSI）的感染率、危险因素、病原菌种类、耐药性及临床结局，对有效抗感染治疗及预防CRBSI的发生提供指导。方法 回顾性分析2010年4月~2014年4月共483例留置过中心静脉导管（CVC）的患者。计算感染率、感染相关性因素及筛选危险因素分析并应用SPSS20.0统计软件进行多因素Logistic回归分析。结果 共有17例患者发生CRBSI，感染率为3.5%；不同置管者、置管地点、置管部位构成的比较，差异有统计学意义（P<0.05）。经多因素Logistic回归分析，发现影响CRBSI的独立危险因素是抗生素大量使用和导管日，OR值分别为7.898和1.044。革兰阳性菌（gram-positive bacteria，G+）占35.3%，革兰阴性菌（gram-negative bacteria，G-）占47.1%，真菌占17.6%；G+菌感染患者，经治疗后病情100% 好转；G-菌感染患者，87.5% 好转，12.5% 恶化；真菌感染患者，66.7% 好转，33.3% 恶化。结论 CRBSI的发生率随抗生素大量使用以及导管日延长而增加。患者经治疗后，大部分好转，但真菌感染者病死率相对较高，应引起临床关注。 |
| 中文关键词:中心静脉导管 血流感染 病原学 |
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| Retrospective Investigation and Analysis of Clinical and Etiological of Central Venous CRBSIs |
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| Abstract:Objective To study central related blood stream infection (CRBSI) related prevalence, risk factors, pathogens, drug resistance and clinical outcomes in ICU ward, to provide the guidance for how to provide effective anti-infection treatment, and better prevention of CRBSI occur. Methods A total of 483 patients, who had indwelled central venous catheters in the ICU during April 2010 to April 2014,were retrospectively ananlyzed. The infection rate was calculated and the risk factors were screened before multiple Logistic regression analysis of the likely risk factors in SPSS20.0 was conducted. Results There were totally 17 cases led to CRBSI, with the rate of infection number of 3.5%. Between different catheter, catheter site, catheter site formed, the difference had statistical significance(P<0.05). By Multiple Logistic regression analysis, we found the main risk factors of CRBSI were the extensive use of antibiotics and time of CVC, with OR rate 7.898 and 1.044 by respectively. In detected 17 strains pathogens, the gram-positive bacteria(G+) accounted for 35.3%, the gram-negative bacteria(G-) accounted for 47.1% and the fungal accounted for17.6%. The patients who infected G+ after treatment, 100% were cured; G- infection, 87.5% were cured, 12.5% were worsen; fungal infection, 66.7% were cured, 33.3% were worsen. Conclusion The incidence of CRBSI increased accompany with prolonged catheter days and extensive use of antibiotics. Patients after treatment, most were cured, but those fungal infections easily cause high mortality, should lead to clinical attention. |
| keywords:Central venous catheter Blood stream infections Etiological |
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