血液透析患者中心静脉导管留置发生导管相关性感染的特点单中心分析

发布时间：2017-12-28 14:18

本文关键词：血液透析患者中心静脉导管留置发生导管相关性感染的特点单中心分析　出处：《中华医院感染学杂志》2017年11期 　论文类型：期刊论文

【摘要】：目的总结血液透析患者中心静脉留置导管相关性感染(CRI)的菌群分布和药敏分析结果,为临床预防治疗中心静脉CRI提供参考。方法选取2015年1月-2015年12月于医院血液透析中心接受血液透析治疗的365名患者,将在透析治疗过程中并发CRI 58例患者为感染组,将未感染307名患者为对照组,分析总结应用CRI相关影响因素,并对CRI患者进行菌群分布和药敏检测。结果本实验中,CRI发生率15.89%,Logistic分析发现高龄、多次穿刺、长期留置导管、合并糖尿病为CRI独立危险因素(P0.05);CRI患者主要为革兰阳性菌属感染(60.67%),金黄色葡萄球菌为感染率最高菌种(22.47%)。革兰阳性菌主要对青霉素、头孢类有高耐药性,而对利奈唑胺耐药性低,革兰阴性菌则主要对头孢菌素有高耐药性,对莫西沙星、阿卡米星耐药性低。结论高龄、多次穿刺、长期留置导管、合并糖尿病是血液透析患者并发中心静脉留置导管相关性感染的独立危险因素,其感染菌群主要以革兰阳性菌为主,不同感染菌种在药敏结果上有明显差异,应重视病原菌鉴定和药敏分析的价值。
[Abstract]:Objective to summarize the distribution and drug sensitivity analysis of central venous catheter related infection (CRI) in hemodialysis patients, and to provide reference for clinical prevention and treatment of central venous CRI. Methods from January 2015 December -2015 year in hospital hemodialysis center 365 patients received hemodialysis treatment, in the dialysis treatment process of 58 patients with CRI infection group, the infection of 307 patients in the control group, analyze and summarize the related factors affecting the application of CRI, and the distribution of bacteria and drug sensitivity test of CRI patients. The results of this experiment, the incidence rate of CRI was 15.89%, Logistic analysis showed that age, repeated puncture, long-term indwelling catheter, diabetes as independent risk factors for CRI (P0.05); CRI patients were mainly G infection (60.67%), gram positive bacteria Staphylococcus aureus infection rate (22.47% strains). The main Gram-positive bacteria to penicillin and cephalosporins have high resistance and low resistance to linezolid, gram negative bacteria are mainly to have high resistance to cephalosporins, moxifloxacin, Kamil star low resistance. Conclusion age, multiple puncture, long-term indwelling catheter and diabetes were independent risk factors of catheter-related infections in hemodialysis patients with central venous indwelling, the infection of bacteria mainly dominated by Gram positive bacteria, there were obvious differences in the susceptibility of different infectious bacteria, should pay attention to the analysis of pathogen identification and drug sensitivity value.
【作者单位】：郑州大学附属洛阳中心医院肾病风湿免疫科;
【基金】：河南省卫生厅基金资助项目(201209890K)
【分类号】：R692.5
【正文快照】： 终末期肾病患者肾脏功能严重不全,无法将体内毒素有效排除体外,肾脏替代疗法是目前临床治疗终末期肾病最有效的手段。维持血液透析作为目前临床延长终末期肾病患者生存时间最主要的方法,是临床应用率最高的肾脏替代疗法[1-2]。随着血液透析时间的延长,临床导管留置时间随之延

【相似文献】