血透患者导管相关性血流感染菌群分布及易感因素单中心分析.docVIP

心分析 2018-04-08 09:50:18中国现代医生2018年4期 费丹峰陈琪王霄一 ［摘要］戸的 探讨木屮心血透患者屮心静脉导管相关性血流感染(catheter-related blood stream infection, CRBSI)的感染率、菌群分布及易感因素，为指导临床预防及治疗提供数据支持。方法回 顾性分析湖州市第一人民医院血透中心2015年3月?2017年3月间以中心静脉置管建立血管通路 进行血液透析的患者259例，研究分析导管相关血流感染的发生率、病原菌分布及易感因素。结果在 259例行中心静脉置管患者中，共发生导管相关性血流感染30例，占11.58%：病原菌分布以革兰阳 性菌为主，占感染总数的66.67%,其屮金黄色葡萄球菌6株，占20.00%,表皮葡萄球菌5株，占 16.67%；导管留置时间2周、血红蛋白100 g/L.白蛋白v40g/L、BMK18.5 kg/m2^合并糖尿病 是血液透析患者并发CRBSI的相关易感因素(PvO.05)。结论本中心导管相关性血流感染发生率 11.58%,病原菌分布以革兰阳性菌为主，导管留迟时间过长、血红蛋白水平偏低、血清白蛋白水平 偏低、BMI值偏低以及合并糖尿病是发牛导管相关血流感染的易感因素。 ［关键词］血液透析；屮心静脉导管；导管相关性血流感染；病原菌；易感因素 ［中图分类号］R692.5 ［文献标识码］B ［文章编1673-9701 (2018) 04-0047-04 ［Abstract］ Objective To investigate the infection rate, pathogens distribution and susceptible factors of catheter-related blood stream infection (CRBSI) in hemodialysis patients of the center and provide data support for clinical prevention and treatment. Methods 259 hemodialysis patients who established vascular access by central venous catheter in hemodialysis center of Huzhou First Peoples Hospital from March 2015 to March 2017 were retrospectively analyzed. The incidenee, pathogen distribution and susceptibility factors of catheter-related blood stream infections were studied and analyzed. Results Among 259 patients with central venous catheterization, 30 cases of catheter-related blood stream infections occurred, accounting for 11.58%? Gram-positive bacteria dominated in the distribution of pathogen and were accounted for 66.67% of the total, with 6 strains of golden yellow grape cocci, accounting for 20.00% and 5 strains of Staphylococcus epidermidis, accounting for 16.67%? Catheter indwelling time2 weeks, hemoglobinM00 g/L, albumin40 g/L, BMI18.5 kg/m2 and the combination with diabetes were the CRBSI-related susceptible factors in hemodialysis patients(P0.05 ). Conclusion The incidenee of catheter-related blood stream infection in this center is 11.58%? Gram-positive bacteria dominate in pathogenic bacteria .In dwelli ng catheter for too lon