导管相关性血流感染的病原菌检测及危险因素分析

发布时间：2019-01-19 17:23

【摘要】：目的探讨本院导管相关性血流感染(CRBSI)的病原菌分布及其耐药性情况,并分析相关危险因素,为临床治疗提供依据。方法回顾性分析本院2013年1月-2015年12月1 965例置入静脉导管患者的临床和微生物学资料。结果178例确诊为CRBSI,感染率为9.1%,且集中在ICU病房,占81.7%;检出菌株180株,革兰阳性菌占41.7%、革兰阴性杆菌占36.7%、真菌占21.6%;革兰阳性菌整体耐药严重,对万古霉素和利奈唑胺敏感性最高;革兰阴性菌耐药现象亦较严重,对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦和亚胺培南敏感性较高;白色念珠菌对各类抗真菌药物敏感性均较高;高龄、置管时间长和行全胃肠外营养治疗是CRBSI的主要危险因素。结论 CRBSI的病原菌仍以革兰阳性球菌为主,耐药现象严重;应加强相关控制措施,减少CRBSI的发生。
[Abstract]:Objective to investigate the distribution and drug resistance of pathogenic bacteria in catheter-associated blood stream infection (CRBSI) in our hospital and analyze the related risk factors to provide evidence for clinical treatment. Methods the clinical and microbiological data of 1,965 patients with venous catheters from January 2013 to December 2015 were retrospectively analyzed. Results the infection rate of CRBSI, in 178 cases was 9.1% and concentrated in ICU ward (81.7%), 180 strains were detected, gram-positive bacteria accounted for 41.7%, gram-negative bacilli accounted for 36.7%, fungi accounted for 21.6%. Gram-positive bacteria were highly resistant to vancomycin and linazolamine, and Gram-negative bacteria were more sensitive to cefoperazone / sulbactam, piperacillin / tazobactam and imipenem. The sensitivity of Candida albicans to various kinds of antifungal drugs was high, and the main risk factors of CRBSI were the old age, the long time of catheterization and the treatment of total parenteral nutrition. Conclusion Gram-positive cocci are the main pathogens of CRBSI, and the drug resistance is serious, and the related control measures should be strengthened to reduce the occurrence of CRBSI.
【作者单位】：宁波市医疗中心李惠利东部医院;宁波市第二医院;
【基金】：浙江省自然基金项目(Y2110743) 宁波市自然基金项目(2012A610189)
【分类号】：R446.5

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