68例维持性血液透析患者导管相关血流感染及病原菌的分布及其防治对策  

Analysis on Catheter-related Bloodstream Infection and Distribution of Pathogenic Bacteria in 68 Patients with MHD and Their Countermeasures

作　　者：丁少楠 DING Shao-nan(Department of Nephrology,Dengfeng People's Hospital,Dengfeng He'nan 452470,China)

机构地区：[1]登封市人民医院肾内科,河南登封452470

出　　处：《抗感染药学》2020年第12期1783-1786,共4页Anti-infection Pharmacy

摘　　要：目的:探究维持性血液透析(maintenance hemodialysis,MHD)患者导管相关血流感染的因素及主要病原菌的构成及其防治对策。方法:抽取2018年4月—2019年12月期间收治的MHD患者523例临床资料,统计其中心静脉导管血流感染的发生情况,分析其标本的血菌培养结果与感染因素的相关性,以及主要病原菌的构成。结果:523例MHD患者标本中,导致血流感染68例,并分离出81株病原菌(其中革兰阳性菌50株,占61.73%;革兰阴性菌24株,占29.63%;真菌7株,占8.64%);血流感染与患者年龄、合并症、中心静脉置管部位、维持性血液透析时间、置管时间及血清白蛋白水平等因素均具有相关性(P<0.05),构成独立危险因素。结论:MHD相关导管感染的发生受多种因素的影响,以革兰阳性菌感染为主,诊疗中应高度重视感染相关的防控措施,临床应根据药敏试验结果合理选用抗菌药物。Objective:To explore and analyze the factors of maintenance hemodialysis(MHD),the composition of major pathogenic bacteria and their prevention and treatment measures.Methods:The clinical data of 523 MHD patients admitted from April 2018 to December 2019 were collected,and the incidence of central venous catheter bloodstream infection was analyzed.The correlation between the blood culture results of the samples and infection factors was analyzed,as well as the components of the main pathogenic bacteria.Results:Among the 523 MHD patients,68 were infected with blood flow,and 81 strains of pathogenic bacteria were isolated(among which 50 strains of Gram-positive bacteria accounted for 61.73%,24 strains of Gram-negative bacteria accounted for 29.63%and 7 strains of fungi accounted for 8.64%).Blood flow infection was correlated with age,complications,central venous catheterization site,duration of MHD,duration of catheterization,and serum albumin level of patients(P<0.05),which constituted independent risk factors.Conclusion:The occurrence of MHD-related catheter infection is affected by many factors,mainly Gram-positive bacterial infection.Great attention should be paid to infection-related prevention and control measures in the diagnosis and treatment,and antimicrobial agents should be selected reasonably based on drug sensitivity test results.

关 键 词：维持性血液透析(MHD) 血流感染 革兰阳性菌 

分 类 号：R197.323.4[医药卫生—卫生事业管理]