摘要
目的了解一次性输液接头使用过程中存在的感染风险,寻求防控导管相关性血流感染的干预措施。方法选择ICU 4个时间段56例住院患者的抗生素、输液接头使用及输注营养液体情况进行调查,并采集留置时间≥24h的所有使用中的输液接头进行微生物检测。结果ICU患者抗生素使用率为75.00%,静脉高营养使用率达到67.85%。检测一次性输液接头59套,其中6套检出致病菌,阳性检出率10.17%。检出多重耐药鲍曼不动杆菌3株,表皮葡萄球菌1株,真菌(近平滑假丝酵母菌、白色假丝酵母菌)2株。结论一次性输液接头存在严重的感染风险,应综合循证医学证据督导临床加强深静脉留置管路的更换及充分冲管,特别是输注血液、血浆等营养液体后管路的冲洗、更换,以降低导管相关性血流感染发生。
Objective To explore the risk of infection during the use of the disposable infusion connectors and seek the intervening measures to prevent and control catheter related bloodstream infections （CRBSI）.Methods A cross-sectional study was conducted among 56 ICU inpatients on use of antibacterial medicine,infusion connectors and total parenteral nutrition at four different periods of time and disposable infusion connectors in use with indwelling time≥24 h were given microbiological testing.Results The utilization rate of antibiotics and total parenteral nutrition of ICU inpatients was 75.00％ and 67.85％ respectively.Besides,among 59 sets of the one-time infusion connector tested,six of them were found of pathogens,with the positive rate of 10.17％.Altogether,3 multi-drug resistant acinetobacter baumannii,a staphylococcus epidermidis and 2 fungi（candida parapsilosis and saccharomyces albicans）were detected.Conclusion The improper care of one-time infusion connectors can lead to high risk of bloodstream infection.Deep venous catheterization should be changed and flushed completely,especially after the infusion of blood and plasma,according to the evidence-based medicine,to reduce the occurrence of the CRBSI.
基金
西安交通大学第二附属医院基金资助项目(YJ(HL)201310)
关键词
ICU
中心静脉置管
输液接头
微生物检测
横断面调查
护理干预
ICU
central venous indwelling catheter
infusion connectors
microbiological testing
cross-sectional study
nursing intervention
