中心静脉导管相关性败血症病原菌的临床分析及处理

Analysis and Treatment of Pathogens for Intravascular Catheter-related Sepsis

目的:探讨中心静脉导管相关性败血症(catheter-relatedsepsis,CRS)病人病原菌的分布特点及耐药情况。方法:对40例CRS病人的静脉导管尖端进行培养和药敏试验。结果:CRS常见的致病菌依次为革兰阳性球菌(32/45),真菌(8/45),革兰阴性杆菌(5/45)。革兰阳性球菌以表皮葡萄球菌为主,而且多数对苯唑西林耐药,万古霉素敏感率为100%,白色念珠菌为主要的致病真菌(7/8),革兰阴性杆菌常为耐药菌株。结论:CRS病原菌以革兰阳性球菌为主。CRS的有效处理方法是拔除感染的导管。

Objective： To investigate the distribution of common pathogens and their antibiotic resistance from patients with intravascular catheter-related sepsis （CRS）. Methods： Catheter bacteria culture and antibiotic sensitivity test were performed from 40 patients with CRS. Results： The common pathogens in CRS were Gram-positive cocci （32/ 45）, fungi （8/45） and Gram-negative bacilli （5/45）. The most of strains were staphylococcus epidermidis in Gram- positive cocci and the most of them were Methieillin resistant. No vancomycin resistant strains were found. Candida albicans s l^ecies were major pathogen （7/8）. The Gram-negative bacilli were often resistant to third generation cephalosporins. Conclusions： The dominant pathogens of CRS are Gram-positive cocci. The effective treatment of catheter-related sepsis is removal of the infected catheters.