摘要
目的研究老年胃肠肿瘤患者外周穿刺中心静脉导管(PICC)置管后发生导管相关性感染临床资料,并对病原菌分布和耐药性进行分析,为预防和治疗老年胃肠肿瘤患者PICC置管后感染提供参考。方法选取2011年3月-2014年3月就诊的老年胃肠肿瘤并行PICC置管患者共238例作为研究对象,对患者感染部位送检标本进行细菌培养及药敏试验,研究菌群分布和耐药性。结果 80岁以上患者、高APACHEⅡ评分、股静脉置管、置管时间长、置管次数多、静脉营养患者发生感染的比例较高(P<0.05);共分离病原菌92株,其中革兰阳性菌51株占55.4%,革兰阴性菌36株占39.1%,真菌5株占5.5%;金黄色葡萄球菌对万古霉素敏感,敏感率为100.0%,鲍氏不动杆菌对亚胺培南较敏感。结论针对高龄、高APACHEII评分、股静脉置管、置管时间长次数多、静脉营养的老年胃肠肿瘤患者给予加强监护,根据药敏试验结果进行针对性治疗。
OBJECTIVE To explore the clinical data of the elderly gastrointestinal cancer patients with peripherally inserted central catheter（PICC）-related infections and analyze the distribution and drug resistance of the pathogens so as to provide guidance for prevention and treatment of PICC-related infections in the elderly patients with gastrointestinal cancer.METHODS A total of 238 elderly patients with gastrointestinal cancer who underwent the PICC from Mar 2011 to Mar 2014 were recruited as the study objects.The bacterial culture was carried out for the submitted specimens that were collected from the infection sites,and the drug susceptibility testing was performed,and the distribution and drug resistance of the pathogens were observed.RESULTS The incidence of the PICC-related infections was relatively high in the patients with more than 80 years of age,high APACHEⅡscore,femoral venous catheter indwelling,frequent catheterization,and parenteral nutrition（P〈0.05）.Totally 92 strains of pathogens were isolated,including 51（55.4%）strains of gram-positive bacteria,36（39.1%）strains of gram-negative bacteria,and 5（5.5%）strains of fungi.The drug susceptibility rate of the Staphylococcus aureus to vancomycin was 100.0%;the Acinetobacter baumannii was highly susceptible to imipenem.CONCLUSION It is necessary to strengthen the care of the elderly gastrointestinal cancer patients with advanced age,high APACHEII score,femoral venous catheter indwelling,long and frequent catheterization,and parenteral nutrition and conduct the targeted treatment according to the results of the drug susceptibility testing.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第21期4922-4924,共3页
Chinese Journal of Nosocomiology
基金
山东省自然科学基金资助项目(Y2006C02)
关键词
肿瘤
外周穿刺中心静脉导管
导管相关性感染
危险因素
耐药性
Cancer
Peripherally inserted central catheter
Catheter-related infection
Risk factor
Drug resistance
