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(P<0.05);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。
OBJECTIVE To summarize the distribution and susceptibility analysis results of catheter-associated infection （CRI） of central venous catheters in patients with hemodialysis,so as to provide references for clinical prevention and treatment of central venous CRI.METHODS A total of 365 patients with hemodialysis at the hospital hemodialysis center from Jan.2015 to Dec.2015 were selected as the research objects.The 58 patients with CRI during dialysis treatment were included as infection group,and 307 patients without infection were set as control group.The CRI related factors were analyzed and the distribution and susceptibility of pathogens in CRI patients were detected.RESULTS The incidence of CRI was 15.89 % in this study.Logistic analysis showed that older age,multiple punctures,long-term indwelling catheters and diabetes mellitus were the independent risk factors for CRI （P〈0.05）.CRI patients were mainly infected with gram-positive bacteria （60.67%）,and Staphylococcus aureus had the highest infection rate （22.47%）.Gram-positive bacteria were mainly resistant to penicillin and cephalosporins,but with low resistance to linezolid.Gram-negative bacteria were mainly with high resistance to cephalosporins,and with low resistance to moxifloxacin and acamifloxacin.CONCLUSION Older age,multiple punctures,long-term indwelling catheter and diabetes mellitus are the independent risk factors for CRI of central venous catheters in hemodialysis patients.The infected bacteria are mainly gram-positive bacteria,different infected strains have significantly different drug sensitivity results,and we should pay attention to the value of identification of pathogens and drug sensitivity analysis.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第11期2453-2456,共4页
Chinese Journal of Nosocomiology
基金
河南省卫生厅基金资助项目(201209890K)
关键词
血液透析
中心静脉留置导管
导管相关性感染
病原菌分布
药敏分析
Hemodialysis
Central venous catheter
Catheter-related infection
Pathogen distribution
Susceptibility analysis
