患儿导管相关性放射根瘤菌血流感染实验室诊断方法探讨  

Evaluation on laboratory diagnosis of catheter-related bloodstream infection due to Rhizobium radiobacter in pediatric patients

作　　者：常勇杰[1] 续华东[1] 徐红炜[1] 胡波[2] 张振[3] 

机构地区：[1]咸宁市通城县人民医院,湖北通城437400 [2]中山大学附属第三医院,广东广州510630 [3]武汉市妇女儿童医疗保健中心,湖北武汉430016

出　　处：《中国感染控制杂志》2015年第2期81-84,共4页Chinese Journal of Infection Control

基　　金：教育部留学回国人员科研启动基金(教外司留2012-940)

摘　　要：目的探讨患儿导管相关性放射根瘤菌血流感染的诊断方法和感染因素。方法收集某院2012年2月—2014年2月1 014例使用各类中心静脉导管的患儿资料,检测放射根瘤菌感染患儿导管半定量培养,导管与静脉血菌落数比,以及静脉血与导管培养时间差;分析放射根瘤菌感染危险因素。结果 1 014例使用各类中心静脉导管的患儿,导管和静脉血标本分别培养出放射根瘤菌32例和28例,27例患儿导管血和静脉血均为阳性。导管半定量培养菌落数≥15 CFU者27例,<15 CFU者5例;导管与静脉血菌落数比≥5∶1者22例,<5∶1者6例;静脉血与导管培养时间差≥2 h者26例,<2 h者2例。危险因素分析结果显示,患儿年龄、导管留置时间各组比较差异有统计学意义(均P<0.05)。结论导管半定量培养、导管与静脉血菌落数比值及静脉与导管血培养时间差均是判断导管相关性放射根瘤菌血流感染的重要诊断依据;患儿年龄<2岁、导管留置时间>5 d是导管相关性放射根瘤菌血流感染的危险因素。Objective To evaluate diagnostic method and infection factors for catheter-related bloodstream infec- tion（CRBSI） due to Rhizobium radiobacter （R. radiobacter） in pediatric patients. Methods Clinical data of 1 014 pediatric patients with central venous catheter（CVC）-related treatment in a hospital from February 2012 to February 2014 were collected, semi-quantitative culturing of catheter, colony forming unit （CFU） ratio of catheter to venous blood, difference in culture time between venous blood and catheter were detected among patients with R. radiobact- er infection; factors for R. radiobacter infection were analyzed. Results Of 1 014 pediatric patients who used CVC, 32 were detected R. radiobacter from catheter blood, 28 were detected from venous blood, 27 were detected from both catheter and venous blood. Catheter semi-quantitative culture of 27 patients were ≥15 CFU, 5 were〈15 CFU; CFU ratio of catheter to venous blood of 22 patients were ≥5：1, 6 were〈5：1; difference in culture time be- tween venous blood and catheter of 26 patients were ≥2 hours, 2 were〈2 hours. Risk factor analysis revealed that child＇s age, catheter indwelling time of each group were significantly different （both P〈0.05）. Conclusion Cathe- ter semi-quantitative culture, CFU ratio of catheter to venous blood,and difference in culture time between venous and catheter blood are important diagnostic basis for confirming R. radiobacter bloodstream infection; patients aged 〈2 years, catheter indwelling time 〉5 days are risk factors for R. radiobacter bloodstream infection.

关 键 词：儿科 放射根瘤菌 导管相关性感染 诊断 危险因素 医院感染 

分 类 号：R446[医药卫生—诊断学]