无临床感染症状患者血液透析导管的细菌定植研究  

Study on Bacterial Colonization of Hemodialysis Catheters in Asymptomatic Patients

作　　者：徐丽云[1] 龚瑜 王莎莎 厉春萍[1] 陈德君[1] XU Li-yun;GONG Yu;WANG Sha-sha;LI Chun-ping;CHEN De-jun(Taizhou Hospital of Zhejiang Province)

机构地区：[1]浙江省台州医院

出　　处：《医院管理论坛》2022年第4期58-61,共4页Hospital Management Forum

基　　金：浙江省医药卫生科技计划项目,编号:2020ZH072。

摘　　要：目的 通过无临床感染患者的血透导管尖端的细菌学研究结果以了解导管潜在细菌的定植情况。方法 血透导管使用后,因各种原因需拔除导管(排除临床明确感染),尖端行培养。结果 导管尖端培养结果:阳性65例,占比24.90%。导管细菌定植阳性率与性别、原发病是否为糖尿病及HB水平差异无统计学意义(p>0.05);与年龄、留置位置、导管是否具有涤纶套及ALB水平差异有统计学意义(p<0.05)。培养的细菌以表皮葡萄球菌为主(35.38%)、头状葡萄球菌亚种次之(26.15%)。结论 无临床感染症状患者血透导管有潜在的细菌定植机会,高龄、无涤纶套导管、股静脉位置留置导管、有涤纶套颈静脉留管时间的延长、低白蛋白都是导管定值细菌的高危风险因素。在一定条件下,定植菌大量繁殖,将导致临床导管相关性感染。Objective To understand the potential bacterial colonization of the catheter through the results of bacteriological study on the tip of the hemodialysis catheters in patients without clinical infection. Methods After the hemodialysis catheters were used, the catheters should be removed due to various reasons(excluding clinically definite infection), and their tips were cultured. Results The results of catheter tip culture showed that there were 65 cases positive, accounting for 24.90%. There was no significant difference in the positive rate of bacterial colonization of the catheter with gender, whether the primary disease was diabetes mellitus the level of HB(p>0.05). It was significantly different with age, indwelling position, whether the catheter had a polyester sleeve and the level of ALB(p<0.05). The cultured bacteria were dominated by staphylococcus epidermidis(35.38%), followed by staphylococcus capitis subsp(26.15%). Conclusion Patients without clinical symptoms of infection may have potential bacterial colonization of hemodialysis catheters. The high-risk factors of catheter-valued bacteria include old age, catheters without polyester sleeves, indwelling catheters in femoral veins, prolonged indwelling time of jugular vein catheters with polyester sleeves and low albumin. Under certain conditions, the colonization bacteria would multiply, which may lead to clinical catheter-related infection.

关 键 词：血透导管 医院感染 细菌定植 

分 类 号：R197.3[医药卫生—卫生事业管理]