中长期深静脉留置透析的导管相关性感染菌群分布及药敏分析  

The distribution and drug susceptibility of bacteria from catheter-related infections resulted from medium and long term indwelling venous catheters for hemodialysis

作　　者：何亚仙[1] 姜丽芬[1] 章秀峰[1] 

机构地区：[1]余姚市人民医院泌尿肾病中心,浙江余姚315400

出　　处：《中国微生态学杂志》2015年第4期456-459,共4页Chinese Journal of Microecology

摘　　要：目的探讨中长期深静脉留置透析的导管相关性感染(CRI)菌群分布及药敏分析。方法回顾性分析39例导管相关性感染患者发生率及感染类型,不同置管部位的感染情况,病原菌的种类分布,药敏试验和疗效。结果 106例中长期导管透析的患者中,39例发生导管相关性感染,占36.7%。其中感染率较高的原发病为狼疮肾及糖尿病性肾病。39例标本菌培养阳性,分离出6种病原菌,41株细菌。病原菌分布:革兰阳性球菌24株,占61.5%;革兰阴性杆菌15株,占38.5%。葡萄球菌属最为敏感的抗生素为万古霉素,对于革兰阴性杆菌,亚胺培南和头孢哌酮最为敏感。结论中长期维持性血液透析患者导管相关性感染的发生率较高,只有医护人员严格进行无菌操作,加强环境卫生,积极开展健康宣教,合理使用敏感抗菌药物,防止创口的污染,才能降低CRI的发生率,最终取得良好的临床效果。Objective To explore the distribution and drug susceptibility of the bacteria from catheter related infec- tions （CRIs） resulted from mid- and long-term indwelling venous catheters for hemodialysis. Methods Retrospec- tive analysis was performed on patients with CRIs in terms of the incidence and types of infection, infections at dif- ferent insertion sites, the species and distribution of pathogenic bacteria, drug sensitivity and treatment outcomes. Results In a total of 106 cases included, CRIs occurred in 39 cases, accounting for 36. 7%. The highest inci- dence was seen in primary lupus kidney disease and diabetic nephropathy cases. 41 strains of 6 pathogenic bacteria were isolated from the 39 cases, including 24 strains （61.5%） of gram-positive cocci and 15 strains （38.5%） of gram-negative bacilli. Staphylococcus aureus was the most sensitive to vaneomycin, while gram-negative bacilli was the most sensitive to imipenem and cefoperazone. Conclusion The incidence of CRIs is high in patients accepting mid- and long-term maintenance hemodialysis, which can be reduced only by strict aseptic operation, better envi- ronmental hygiene, active health education actively, rational use of antimicrobial agents, and by prevention of wound contamination.

关 键 词：血液透析 中长期导管留置 病原菌分布 药敏分析 

分 类 号：R378[医药卫生—病原生物学]