先天性心脏病患儿术后中心静脉导管相关性血流感染的调查分析  

Investigation and analysis of postoperative cardiac venous catheter-related bloodstream infections in children with congenital heart disease

作　　者：贾鹏[1] 黄睿[2] 李刚[1] 刘斌[1] 

机构地区：[1]泸州医学院附属医院儿科,四川泸州646000 [2]泸州医学院外国语学院,四川泸州646000

出　　处：《中华医院感染学杂志》2015年第3期688-689,692,共3页Chinese Journal of Nosocomiology

基　　金：四川省卫生厅研究基金资助项目(2011717);泸州市科技局青年基金资助项目(12334)

摘　　要：目的探讨先天性心脏病患儿术后中心静脉导管（cvc）相关性血流感染以及病原菌分布，为临床降低其感染率提供依据。方法选取2011年5月-2013年3月心脏病治疗中心收治的617例实施手术治疗的先天性心脏病患儿，进行中心静脉导管相关血流感染目标性监测，调查研究感染发生率及病原菌分布。结果617例心脏手术患儿留置中心静脉导管，其中12例患儿发生相关性血流感染，感染率为1．94％；相关性血流感染发生时间≤7d的3例占25．00％、8～15d的7例占58．33％、≥15d的2例占16．67％；共检出21株病原菌，检出革兰阴性菌12株占57．14％，革兰阳性菌检出9株占42．86％，其中鲍氏不动杆菌、铜绿假单胞菌、金黄色葡萄球菌占前3位。结论先天性心脏病患儿术后中心静脉导管相关性血流感染率较高，在治疗过程中医护人员要严格按照指导手册，积极主动对患儿实施预防感染的各项措施，降低中心静脉导管相关性血流感染率，缩短患儿的住院时间，降低病死率。OBJECTIVE To investigate postoperative central venous catheter-related bloodstream infections in children with congenital heart disease as well as the distribution of pathogenic bacteria, so as to provide the basis for reducing infection rates. METHODS A total of 617 children with congenital heart disease who underwent surgical treatment in the cardiology center during May 2011 to Mar. 2013 were enrolled. The targeted monitoring of central venous catheter-related bloodstream infections was performed, and the infection incidence and the pathogen distribution were investigated. RESULTS Among the 617 children who underwent cardiac surgery and had indwelling central venous catheters, 12 cases of related bloodstream infections occurred, the incidence was 1.94%. Three eases （25.00%） had related bloodstream infections occurring in 7 days, 7 eases （58. 33%） in 8 - 15 days and 2 eases （16.67%） after 15 days. Totally 21 pathogens were detected, including 12 gram-negative bacteria accounting for 57.14% and 9 gram-positive bacteria accounting for 42.86% , among which Acinetobacter baumannii, Pseudomonas aeruginosa, Staphylococcus aureus accounted for the top three. CONCLUSION The rate of postoperative central venous catheter-related bloodstream infections in children with congenital heart disease is relatively high. In the course of treatment, health care workers should be strictly in accordance with the instruc- tion manual, implement proactive measures to prevent infection in children, reduce central venous catheter-related bloodstream infections, shorten hospital stay in children and reduce mortality.

关 键 词：先天性心脏病 患儿 中心静脉导管 相关性血流感染 调查分析 

分 类 号：R181.32[医药卫生—流行病学]