ICU中心静脉导管相关血流感染的临床特点及相关因素分析

发布时间：2018-02-03 02:48

本文关键词： ICU 中心静脉导管血流感染相关因素　出处：《中华医院感染学杂志》2017年14期 　论文类型：期刊论文

【摘要】：目的分析ICU中心静脉导管相关血流感染的临床特点,探究其相关因素,为预防ICU中心静脉导管相关血流感染提供参考依据。方法选择2006年1月-2016年11月于ICU行中心静脉导管留置的患者610例,采用医院微生物半自动鉴定系统进行细菌分离及鉴定,通过K-B纸片扩散法进行药物敏感性试验,分析患者感染病原菌的分布情况及药敏试验结果,同时搜集患者的病例资料,分析中心静脉导管相关血流感染的危险因素。结果 610例ICU中心静脉导管患者出现血流感染的患者31例,感染率为5.08%,共分离出76株病原菌,以革兰阴性菌为主,共46株占60.53%;革兰阴性菌对青霉素类、喹诺酮类、第三代以下头孢菌素、四环素类、部分氨基糖甙类等抗菌药物耐药性较高,部分可达100.00%;logistic多元素回归分析显示:年龄、患者的意识状态、中心静脉导管留置时间及静脉营养是引起中心静脉导管患者出现相关血流感染的独立危险因素(P0.05)。结论应注意中心静脉导管感染独立危险因素,血培养分离的病原菌中以革兰阴性菌为主,且存在较严重的耐药现象,应针对病原菌合理选用抗菌药物。
[Abstract]:Objective to analyze the clinical characteristics of central venous catheter associated blood flow infection in ICU and to explore its related factors. Methods 610 patients with ICU underwent central venous catheter indwelling from January 2006 to November 2016 were selected. The bacteria were isolated and identified by the hospital microbial semi-automatic identification system. The drug sensitivity test was carried out by K-B disk diffusion method. The distribution of pathogenic bacteria and the results of drug sensitivity test were analyzed. At the same time, the data of the patients were collected, and the risk factors of central venous catheter associated blood flow infection were analyzed. Results 31 cases of ICU patients with central venous catheter infection were found. The infection rate was 5.08. A total of 76 strains of pathogenic bacteria were isolated, mainly Gram-negative bacteria (46 strains accounted for 60.53%). Gram-negative bacteria were resistant to penicillin, quinolones, cephalosporins, tetracyclines, aminoglycosides, etc. Logistic multielement regression analysis showed that age and consciousness status of the patients. Central venous catheter indwelling time and venous nutrition were the independent risk factors for the occurrence of blood flow infection in patients with central venous catheter. Conclusion attention should be paid to the independent risk factors of central venous catheter infection. Gram-negative bacteria were the main pathogens isolated from blood culture, and there was serious drug resistance.
【作者单位】：北京医院加强医疗病房;
【分类号】：R459.5
【正文快照】： ICU患者一般病情均比较复杂,患者的病死率相对比较高[1]。但是ICU患者死亡原因并不一定是来源于原发疾病,部分患者可能因合并严重感染而导致病情恶化死亡。现在临床大部分重症监护室的死亡原因分析中,病原菌感染仍然是首位致死因素[2]。目前国内外患者对于重症监护室的病原菌

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