摘要
目的明确肿瘤化疗患者中心静脉导管(PICC)置管术后导管相关性感染的病原学情况,为预防感染提供参考依据。方法对4964例置管化疗发生导管相关性感染的21例患者进行病原菌及感染相关因素调查和分析。结果导管相关性感染率为0.42%,21例感染患者中14例为置管部位及导管尖端病原菌培养阳性,占66.67%,7例患者无局部感染症状,占33.33%;21例患者均有发热、体温升高等全身感染症状;感染标本中共检出病原菌21株,其中革兰阳性球菌10株占47.62%,革兰阴性杆菌7株占33.33%,真菌4株占19.05%,主原病原菌为表皮葡萄球菌、金黄色葡萄球菌、假丝酵母菌属,分别占23.81%、14.29%、14.29%;年龄≥60岁、PICC留置时间≥7d、留置部位为贵要静脉是感染高发的相关因素。结论加强置管操作与维护管理、尽可能缩短导管留置时间、加强随访、增加患者营养、提高免疫力可降低导管相关性感染的发生。
OBJECTIVE To investigate the prevalence on pathogens causing the catheter-related infections in chemotherapy cancer patients with PICC so as to provide a reference for preventing infections. METHODS The epidemiological investigation was conducted for 21 patients with catheter-related infections in 4964 cancer patients who underwent chemotherapy. RESULTS The incidence rate of the catheter-related infections was 0.42% ; of 21 patients with the infections, there were 14 patients（66. 67%） who had local inflammation and the pathogens propagated around the catheter and positive pathogens in blood, 7 patients（33. 33%）who did not have local inflammation, and all of the patients were suffered from the infection with symptoms of fever and thrill. Totally 21 strains of pathogens were isolated from the infected specimens, including 10 strains（47. 62%） of gram-positive bacteria, 7 strains（33. 3%） of gram-negative bacteria and 4 （19. 05%）strains of fungi. The Staphylococcus epidermidis, Staphylococcus aureus ,and the Candida were the predominant species of pathogens, accounting for 23.81%, 14.29%, and 14. 29%, respectively. The more than 60 years of age, PICC indwelling duration more than 7 days, and catheterization site were the high risk predisposing factors. CONCLUSION Strengthening the management of intubations and catheter maintenance, shortening the indwelling duration, strengthening the management of follow-up, and improving the patientsr nutritional and immune status can reduce the incidence of catcher-related infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第10期2313-2315,共3页
Chinese Journal of Nosocomiology
关键词
肿瘤
中心静脉导管
导管相关性感染
Tumor
Central venous catheter
Catheter-related infection
