老年患者中心静脉导管相关性感染的临床及病原学分析  

Clinical and etiological survey of central venous catheter related infections in gerontal patients

作　　者：钟亚[1] 童莉[1] 

机构地区：[1]武汉大学中南医院综合医疗科,湖北武汉430071

出　　处：《中华医院感染学杂志》2011年第15期3150-3152,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨综合科老年患者中心静脉导管相关性感染的特点、影响因素、病原学分布及耐药性。方法收集医院综合科收治的335例行留置中心静脉导管>60岁患者临床及病原学资料,分为感染组与对照组,对2组资料进行统计学分析。结果 335例患者中,感染48例,感染率14.3%;感染组导管留置时间、胃肠外营养、气管切开、住院时间及费用均高于对照组(P<0.05),白蛋白水平低于对照组(P<0.05);共培养出52株病原菌,革兰阳性球菌24株,占46.2%,革兰阴性杆菌22株,占42.3%,真菌6株,占11.5%;革兰阴性杆菌和革兰阳性球菌均有较高程度的耐药;革兰阳性菌对替考拉宁最敏感,革兰阴性菌对美罗培南、阿米卡星具有较高的敏感性。结论老年患者中心静脉导管相关性感染率与病情危重程度相关,费用明显增高,病原菌耐药严重,在高度怀疑严重导管相关性血流感染(CRBSI)而培养结果尚未回报时,可适当选用替考拉宁联合美罗培南或者阿米卡星治疗。OBJECTIVE To discuss the characteristics of central venous catheter-related infections,influencing factors,pathogen distributions and drug resistances in elderly patients in integrated branch.METHODS Synthesis were admitted in our hospital over the age of 60 patients with indwelling central venous catheter and the etiology of 335 cases of clinical information,and were divided into the infected group and the control group,48 cases of 287 cases,of the 2 groups were statistically analyzed.RESULTS Totally 48 cases of 335 cases were infected（14.3%）.Catheter time of infection,parenteral nutrition（PN） rate,tracheotomy rate,hospital stay and costs were higher（P0.05）,albumin level lower than that of the control group（P0.05）;of 52 pathogens strains,Gram-positive cocci 24（46.2%）,Gram-negative bacilli 22（42.3%）,6 strains of fungi（11.5%）.Gram-negative bacilli and Gram-positive bacteria had a higher degree of resistance.Gram-positive bacteria were most sensitive to teicoplanin and Gram-negative bacteria to meropenem,amikacin were with high sensitivity.CONCLUSION The rate of central venous catheter-related infections in gerontal patients is related to the severity of diseases,and the cost is significantly increased,it is suitable to choose teicoplanin combined with meropenem of amicacin.

关 键 词：老年患者 中心静脉导管 感染 病原学 

分 类 号：R181.32[医药卫生—流行病学]