中国血液净化

中国血液净化

• 临床研究 • 上一篇    下一篇

血液透析患者导管相关血流感染菌群分布及危险因素分析

  

  1. 天津市宝坻区人民医院肾内科
  • 收稿日期:2012-04-25 出版日期:2012-10-12 发布日期:2013-01-04
  • 通讯作者: 安自民

Bacterial distribution and risk factors for catheter-related bloodstream infection in hemodialysis patients

  • Received:2012-04-25 Online:2012-10-12 Published:2013-01-04

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摘要： 【摘要】目的 探讨血液透析患者导管相关血流感染的菌群分布及相关危险因素。方法 回顾性分析天津市宝坻区人民医院2008～2011年以中心静脉置管建立血管通路进行血液透析的患者219例，分析导管相关血流感染的发生率，病原菌分布及相关危险因素。结果 在219例行中心静脉置管患者中，发生导管相关血流感染34例，占15.52%，病原菌分布以革兰氏阳性菌为主，占感染总数的61.76%，其中表皮葡萄球菌13株，占38.23%，金黄色葡萄球菌5株，占14.70%，股静脉插管的感染率并不显著高于颈内静脉插管(χ2=0.914，P=0.339)；导管留置时间与导管相关性血流感染呈正相关(χ2=13.350，P=0.001)；与基础疾病无明显相关性(χ2=0.284，P=0.991)。结论 导管相关血流感染病原菌分布以革兰氏阳性菌为主，发生导管相关血流感染的危险因素与导管留置时间有关。

关键词: 血液透析, 中心静脉导管, 血流感染, 病原菌

Abstract: 【Abstract】Objective To explore the bacterial distribution and risk factors for catheter-related bloodstream infection in hemodialysis patients.  Methods We retrospectively studied 219 patients established a central venous catheter as vascular access for hemodialysis in our hospital from 2008 to 2011. The incidence of catheter-related bloodstream infection, the pathogen distribution and the related risk factors for the infection were analyzed. Results Thirty-four (15.52%) of the 219 patients with a central venous catheter suffered from catheter-related bloodstream infection, of which the main pathogens were Gram-positive bacteria (21 cases, 61.76%), including staphylococcus epidermidis 13 cases (38.23%) and staphylococcus aureus 5 cases (14.70%). The rate of catheter-related bloodstream infection was similar between the patients with femoral vein catheters and those with internal jugular vein catheters (χ2=0.914, P=0.339). Catheter-related bloodstream infection was positively related to indwelling time of catheters (χ2=13.350, P=0.001), but was unrelated to the underlying diseases (χ2=0.284, P=0.991). Conclusions The main pathogens responsible for the catheter related bloodstream infection were Gram-positive bacteria. The indwelling time of catheters was the risk factor for catheter-related bloodstream infection.

Key words: Hemodialysis, Central venous catheter, Bloodstream infection, Pathogens