摘要
目的分析导管相关性血流感染(CRBSI)与中心静脉导管(CVC)堵塞的关系及病原菌分布情况。方法收集2019年3月-2021年3月于医院进行中心静脉穿刺或携带中心静脉导管的患者660例,分析患者CRBSI感染与CVC堵塞情况,对CRBSI感染患者病原菌分布、耐药性进行分析,并分析影响CRBSI感染的危险因素。结果CRBSI感染与CVC堵塞之间存在相关性(r=0.652,P<0.001);60例CRBSI感染患者置管血中共分离得到病原菌69株,其中革兰阳性菌45株(65.22%),以肠球菌和金黄色葡萄球菌为主,革兰阴性菌22株(31.88%),以肺炎克雷伯菌和鲍氏不动杆菌为主;主要革兰阳性菌对青霉素类、红霉素类抗菌药物耐药性较高,主要革兰阴性菌对青霉素类、头孢菌素抗菌药物耐药性较高;Logistic分析结果显示,置管时间、置管部位是CRBSI感染的影响因素(P<0.05)。结论CRBSI感染与CVC堵塞密切相关,导管感染病原菌以革兰阳性菌为主,且置管时间、置管部位是CRBSI感染的影响因素,临床可据此制定防控措施。
OBJECTIVE To analyze the relationship between CRBSI and CVC occlusion and the distribution of susceptible strains.METHODS Total of 660 patients who underwent central venous puncture or carrying central venous catheter in the hospital between Mar 2019 and Mar 2021 were enrolled.CRBSI infection and CVC occlusion in patients were analyzed,and the distribution and drug resistance of pathogenic bacteria were analyzed among patients complicated with CRBSI infection,and the risk factors affecting CRBSI infection were analyzed.RESULTS There was a significant correlation between CRBSI infection and CVC occlusion(r=0.652,P<0.001).A total of 69 strains of pathogenic bacteria were isolated from the catheterization blood of 60 patients with CRBSI infection,including 45 strains(65.22%)of gram-positive bacteria(mainly Enterococcus and Staphylococcus aureus),22 strains(31.88%)of gram-negative bacteria(mainly Klebsiella pneumoniae and Acinetobacter baumannii).The main gram-positive bacteria were highly resistant to penicillin and erythromycin,while the main gram-negative bacteria were highly resistant to penicillin and cephalosporin.Multivariate logistic analysis showed that catheterization time and catheterization site were the risk factors affecting CRBSI infection(P<0.05).CONCLUSION CRBSI infection is closely related to CVC occlusion.Gram-positive bacteria are the main pathogens of catheter infection,and catheter placement time and location are risk factors for CRBSI infection,so clinical prevention and control measures can be formulated accordingly.
作者
刘洪
贺婷
陈利红
彭福南
熊波
LIU Hong;HE Ting;CHEN Li-hong;PENG Fu-nan;XIONG Bo(Pingciang People's Hospital,Pingxiang,Jiangri 337000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2023年第7期1117-1120,共4页
Chinese Journal of Nosocomiology
基金
萍乡市科技局科研项目(2019PY085)。
关键词
导管相关性血流感染
中心静脉导管
病原菌
相关性
耐药性
危险因素
Catheter-related bloodstream infection
Central venous catheter
Pathogen
Correlation
Drug resistance
Riskfactors
