导管相关血液透析感染的病原学调查分析  

Etiological Investigation and Analysis of Catheter-related Hemodialysis Infection

作　　者：陈璐[1] 罗彩霞 黄俊李 林晓 CHEN Lu;LUO Caixia;HUANG Junli;LIN Xiao(Meizhou People’s Hospital,Meizhou 514031,China)

机构地区：[1]广东省梅州市人民医院,广东梅州514031

出　　处：《中国医学创新》2020年第27期164-167,共4页Medical Innovation of China

摘　　要：目的:了解经深静脉置管引起的血液透析相关性感染的常见致病菌的分布情况。方法:回顾性分析2016年10月-2018年9月本院收治的402例深静脉留置导管血液透析患者的临床资料,统计导管相关性感染发生情况、病原菌分布情况,比较导管长期留置与短期留置患者感染情况及导管长期留置与短期留置患者病原菌分布情况。结果:402例患者中,58例发生导管相关性感染,占比14.43%(58/402);13例患者管腔内血液培养、导管顶端病原体培养阳性;发生相关性感染的患者中,约81%的患者进行了病原学检测,共检出54株常见病原菌,其中26株为革兰阳性菌、27株为革兰阴性菌、1株为真菌。导管长期留置患者感染率为16.34%,与导管短期留置患者的13.76%比较,差异无统计学意义(P>0.05);导管长期留置患者病原菌检出率为15.38%,与短期留置患者的12.75%比较,差异无统计学意义(P>0.05)。结论:血液透析患者深静脉留置导管留置时间与相关性感染发生率有着极为密切的联系,金黄色葡萄球菌、阴沟肠杆菌是相关性感染的常见病原菌,临床应根据细菌培养、药敏试验结果,合理选用抗生素。Objective:To understand the distribution of common pathogenic bacteria in hemodialysis-related infections caused by deep vein indwelling catheter.Method:The clinical data of 402 hemodialysis patients with indwelling catheter in our hospital from October 2016 to September 2018 were retrospectively analyzed,the incidence of catheter-related infection and the distribution of pathogens were counted.The infection of patients with long-term and short-term indwelling catheter and the distribution of pathogens in patients with long-term and short-term indwelling catheter were compared.Result:Among 402 patients,58 cases (14.43%) had catheter related infection.13 patients were positive in blood culture in lumen and pathogen culture in catheter tip.Among the patients with associated infection,about 81% had been tested for etiology,and a total of 54 strains common pathogenic bacteria were detected,among which 26 strains were gram-positive bacteria,27 strains were gram-negative bacteria and 1 strains was fungus.The infection rate of patients with long-term catheter indwelling was 16.34%,compared with 13.76% of patients with short-term catheter indwelling,the difference was not statistically significant (P>0.05).The detection rate of pathogenic bacteria in patients with long-term catheter indwelling was 15.38%,compared with 12.75% in patients with short-term indwelling,the difference was not statistically significant (P>0.05).Conclusion:The duration of deep vein indwelling in hemodialysis patients is closely related to the incidence of associated infection.Staphylococcus aureus and Enterobacter cloacae are common pathogens of associated infection,so antibiotics should be selected reasonably in clinical practice according to the results of bacterial culture and drug sensitivity test.

关 键 词：深静脉留置导管 血液透析 相关性感染 致病菌 

分 类 号：R446.5[医药卫生—诊断学] R692.5[医药卫生—临床医学]