某院ICU连续血液净化患者导管相关性感染的危险因素及病原菌特点  

Risk factors and pathogen characteristics of catheter-related infection in ICU patients with continuous blood purification

作　　者：陈洪英[1] 张文源[1] 杨伟英[1] 杨丹丹 CHEN Hong-ying;ZHANG Wen-yuan;YANG Wei-ying;YANG Dan-dan(Taizhou Hospital of Zhejiang Province,Taizhou Zhejiang 317000,China)

机构地区：[1]浙江省台州医院,浙江台州317000

出　　处：《中国消毒学杂志》2020年第11期829-831,836,共4页Chinese Journal of Disinfection

摘　　要：目的探讨重症监护病房(ICU)连续血液净化患者导管相关性感染的危险因素及病原菌特点。方法回顾性分析398例在ICU行连续血液净化患者的病历资料,对影响患者发生导管相关性感染的危险因素及病原菌特点进行分析。结果ICU行连续血液净化的398例患者中,共有57例(14.32%)发生导管相关性感染,培养出61株病原菌,其中革兰阳性菌34株,占55.74%;革兰阴性菌21株,占34.43%;真菌6株,占9.84%。Logistic回归分析结果发现,年龄≥60岁、合并糖尿病、ICU住院时间≥14 d、导管留置时间≥10 d、APACHE II评分数值≥10分以及使用免疫抑制剂等是ICU连续血液净化患者发生导管相关性感染的危险因素(OR>1,P<0.05)。结论ICU连续血液净化患者导管相关性感染的病原菌以革兰阳性菌为主,但革兰阴性菌也占有一定的比例,导管相关性感染的发生率较高,与多种因素关系较为密切,应引起临床医务工作者的重视。Objective To explore the risk factors and pathogen characteristics of catheter-related infection in ICU patients with continuous blood purification.Methods The clinical records of 398 patients undergoing continuous blood purification in ICU were analyzed retrospectively,and the risk factors and pathogen characteristics that affected patients’catheter-related infections were analyzed.Results Among the 398 patients undergoing continuous blood purification in ICU,57(14.32%)had catheter-related infections,and 61 pathogens were cultured in 57 patients with catheter-related infections.34 strains(55.74%),21 strains(34.43%)and 6 strains(9.84%)were Gram-positive bacteria,Gram-negative bacteria and fungi,respectively.The results of Logistic regression analysis showed that age≥60 years old,diabetes mellitus,length of stay in ICU≥14 days,catheter indwelling time≥10 days,APACHE II score≥10 points and use of immunosuppressant were the risk factors of catheter-related infection in patients with continuous blood purification in ICU(OR>1,P<0.05).Conclusion Gram-positive bacteria are the main pathogens of catheter-related infections in ICU patients with continuous blood purification,but Gram-negative bacteria also account for a certain proportion.The incidence of catheter-related infections is relatively high,which is closely related to many factors.So it should be paid attention to by clinical medical workers.

关 键 词：重症监护病房 血液净化 导管相关性感染 致病体 影响因素 

分 类 号：R187[医药卫生—流行病学]