血液透析患者中心静脉导管相关性血流感染的病原菌分布与耐药性及相关因素分析

发布时间：2018-07-11 09:54

本文选题：中心静脉导管 + 血液透析　；参考：《中华医院感染学杂志》2017年21期

【摘要】：目的分析经中心静脉导管(CVC)血液透析患者导管相关性血流感染(CRBSI)的病原菌分布、耐药性及相关因素,为医院感染预防和控制工作提供客观依据。方法选取2012年1月-2016年12月经CVC血液透析治疗的患者146例作为研究对象,对其CRBSI的发生率、临床资料、血液指标及发生CRBSI患者CVC血液样本中的病原菌分布、耐药性进行观察和比较。结果有61例患者发生CRBSI,感染率为41.8%;logistic多元回归分析显示,合并糖尿病、NE≥70%、sCr≥750μmol/L、RBC3×1012/L、Alb35g/L、Hb90g/L是CVC血液透析患者发生CRBSI的独立危险因素(P0.05);分离出67株病原菌,其中,革兰阳性菌40株占59.70%、革兰阴性菌25株占37.31%、真菌2株占2.99%;革兰阳性菌对青霉素G等药物的耐药率较高,革兰阴性菌对头孢曲松等药物的耐药率较高。结论 CVC血液透析合并CRBSI的病原菌分布、耐药性和相关危险因素具有一定的特征性,临床医务人员应对其进行准确的识别和有效的干预,选用敏感抗菌药物进行抗感染治疗,从而降低血液透析患者导管相关性血流感染的发生率。
[Abstract]:Objective to analyze the distribution, drug resistance and related factors of catheter-associated blood stream infection (CRBSI) in patients undergoing central venous catheter (CVC) hemodialysis, so as to provide objective basis for the prevention and control of nosocomial infection. Methods 146 patients with CVC hemodialysis from January 2012 to December 2016 were selected as study subjects. The incidence of CRBSI, clinical data, blood indexes and the distribution of pathogenic bacteria in CVC blood samples of CRBSI patients were analyzed. Drug resistance was observed and compared. Results there were 61 patients with CRBSI.The logistic regression analysis showed that the incidence rate of CRBSIwas 41.8%. Logistic regression analysis showed that RBC3 脳 1012% Alb 35g / L Hb90g / L was an independent risk factor for CRBSI in patients with CVC hemodialysis, 67 pathogenic bacteria were isolated, among which, 67 strains were isolated. 40 Gram-positive bacteria accounted for 59.70%, 25 Gram-negative bacteria 37.31 and 2 fungi 2.99.The resistance rate of Gram-positive bacteria to penicillin G and Gram-negative bacteria to ceftriaxone and other drugs was higher. Conclusion the pathogenic bacteria distribution, drug resistance and related risk factors of CVC hemodialysis combined with CRBSI have some characteristics. Clinical medical personnel should carry out accurate identification and effective intervention, and select sensitive antimicrobial agents for anti-infection therapy. In order to reduce the incidence of catheter-related blood flow infection in hemodialysis patients.
【作者单位】：安徽医科大学第二附属医院血液净化中心;
【基金】：安徽省卫生厅基金资助项目(2014ZY30)
【分类号】：R446.5;R459.5

【相似文献】