摘要
目的对深静脉留置导管导致血液透析患者相关性感染的因素、常见致病菌、临床特征等进行分析研究,探讨有效的预防和治疗措施,减少患者相关性感染的发生。方法 2011年3月-2012年8月对328例深静脉留置导管血液透析患者的临床资料进行回顾性分析,统计发生感染病原菌及药敏试验结果与相关导致感染的因素,采用SPSS17.0软件进行统计分析。结果 328例深静脉留置导管血液透析患者发生相关性感染35例,感染率为10.67%;均送检细菌培养,送检率100.00%;检出病原菌42株,革兰阳性菌占64.29%、革兰阴性菌占30.95%、真菌占4.76%,其中以金黄色葡萄球菌和表皮葡萄球菌为主,分别占30.95%和19.05%;长期留置导管98例患者感染率为16.33%,临时留置导管230例患者,感染率为8.26%,差异有统计学意义(P<0.05)。结论深静脉留置导管血液透析相关性感染病原菌以革兰阳性菌为主,留置导管的时间是影响感染发生的主要因素,加强医院感染的管理、实施针对性的预防措施、合理使用敏感抗菌药物等,可有效降低与治疗相关性感染。
OBJECTIVE To study the influencing factors for deep venous indwelling catheter‐related infections in pa‐tients undergoing hemodialysis ,observe the common species of pathogens ,analyze the clinical characteristics ,and put forward effective prevention and treatment measures so as to reduce the incidence of catheter‐related infec‐tions .METHODS The clinical data of 328 patients who underwent the deep venous indwelling catheter hemodialysis from Mar 2011 to Aug 2012 were retrospectively analyzed ,and the statistical analysis of the distribution of the pathogens causing infections ,the results of drug susceptibility testing ,and the related factors for infections was performed by using SPSS17 .0 software .RESULTS The deep venous indwelling catheter‐related infections occurred in 35 of 328 hemodialysis ,with the infection rate of 10 .67% .All the patients with infections were submitted for bacterial culture ,with the submission rate of 100 .00% .A total of 42 strains of pathogens have been isolated ,a‐mong which the gram‐positive bacteria accounted for 64 .29% ,the gram‐negative bacteria 30 .95% ,the fungi 4 .76% ;the Staphylococcus aureus and Staphylococcus epidermidis were the predominant species of pathogens , accounting for 30 .95% and 19 .05% ,respectively .The infection rate was 16 .33% in the 98 patients undergoing long‐term catheter indwelling and 8 .26% in the 230 patients undergoing temporary catheter indwelling ,there was statistically significant difference （P〈0 .05） .CONCLUSION The gram‐positive bacteria are dominant among the pathogens causing deep venous indwelling catheter‐related infections in the patients undergoing hemodialysis ,and the catheter indwelling time is the leading cause of the infections .It is an effective way to strengthen the manage‐ment of nosocomial infections ,take targeted prevention measures ,and reasonably use sensitive antibiotics so as to reduce the incidence of the infections .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第5期1094-1096,共3页
Chinese Journal of Nosocomiology
基金
湖北省教育厅青年基金资助项目(Q200629002)
关键词
血液透析
深静脉留置导管
感染
病原菌
Hemodialysis
Deep venous indwelling catheter
Infection
Pathogen
