透析患者临时静脉导管相关感染调查研究及耐药性分析  

Investigation and drug resistance of temporary venous catheter related infections in dialysis patients

作　　者：杨璐[1] 张赟[1] 李娅[1] 孟梅霞[1] 

机构地区：[1]西安市第四医院,西安710004

出　　处：《陕西医学杂志》2016年第10期1428-1429,共2页Shaanxi Medical Journal

基　　金：陕西省卫计委科技基金资助项目(2010H17)

摘　　要：目的:探讨透析患者导管相关感染病原菌的分布及其耐药情况,为临床合理使用抗生素提供指导。方法:采用培养导管周边分泌物和血液的方法,分析透析病人导管相关感染的状况。结果:110例透析患者中,发生导管相关感染26例,感染率23.64%;导管出口部分局部感染8例,全身感染引起菌血症18例。分离病原菌26株,以革兰阳性球菌为主,占73.08%(19/26)。革兰阳性球菌对青霉素、苯唑西林、红霉素、克林霉素、四环素的耐药率较高,均>60%;革兰阴性杆菌对头孢曲松的耐药率均>70%。结论:临时静脉导管在透析患者中的感染率较高,临床应积极采取措施,预防导管相关血行感染的发生。同时提高对导管相关感染标本病原菌的检出率,加强对导管相关感染早期诊断。Objective：To investigate the distribution of pathogenic bacteria and drug resistance in patients with hemodialysis,and provide guidance for clinical rational use of antibiotics.Methods：By culturing the peripheral secretion of the catheter and blood from patients with dialysis the catheter related infection was analyzed.Results：A total of 110 patients with catheter related infections occurred in 26 patients,and the infection rate was 23.64%.8cases of local infection of catheter,Systemic infection in 18 patients with bacteremia.26 strains of pathogenic bacteria were isolated,Gram positive bacteria accounted for 73.08%（19/26）.The drug resistance rate of Gram positive bacteria to Penicillin,oxacillin,erythromycin,clindamycin,tetracycline were all over 60%;the drug resistance rate of Gram negative bacteria to ceftriaxone were over 70%.Conclusion：The infection rate of temporary venous catheters in hemodialysis patients is higher,measures should be taken to prevent the occurrence of catheter related infections.At the same time,detection rate of pathogenic bacteria about catheter related infection should be improved,and the early diagnosis of catheter related infection should be strengthened.

关 键 词：血液透析滤过 导管 留置 细菌感染 微生物敏感性试验 

分 类 号：R181[医药卫生—流行病学]