静脉插管相关感染的病原学分析

Analysis of pathogenic microorganisms in intravascular catheter related infections

目的通过分析静脉插管相关感染微生物的病原分布,为临床治疗提供依据和经验。方法通过同时静脉插管标本的常规培养和血培养仪的血培养来确定静脉导管引起的感染,再用微生物鉴定仪辅以手工法对感染微生物进行鉴定。结果420例静脉导管及420例血培养标本,共有104例同时检出病原微生物,检出菌种16种,阳性检出率24.76%。革兰阳性球菌占40.38%(42/104),其中凝固酶阴性葡萄球菌占26.92%(28/104),革兰阴性杆菌占38.46%(40/104),革兰阳性球菌与革兰阴性杆菌感染相比差异无统计学意义(P>0.05)。检出微生物排前8位的分别是表皮葡萄球菌、金黄色葡萄球菌、大肠埃希菌、白假丝酵母菌、近平滑假丝酵母菌、洛菲不动杆菌、铜绿假单胞菌和阴沟肠杆菌。结论静脉插管相关感染病原微生物以细菌和真菌为主,其中最多见的是革兰阳性球菌与革兰阴性杆菌。

Objective To provide the evidence and experience for clinic diagnosis and therapy by investigating the distribution of intravascular catheter related infections. Methods The routine culture of intravascular catheter and blood culture with the instrument were executed at the same time for suspicious intravascular catheter related infections, then microbiology was identified by Vitek 32 and manual method. Results The disease germs were simultaneously found in 104 cases among 420 culture specimens of intravascular catheter and 420 blood culture specimens. 16 sorts of bacteria were detected, the positive rate was 24.76%. Among them, Gram positive coccus was 40. 38% （42/104）, Gram negative bacillus was 38.46 % （40/104）. There was no statistical significance between Gram positive coccus and Gram negative bacillus. The former eight ranks were Staphyloccous epidermidis, Staphyloccous aureus, E. coli, Candida albicans, Candida parapsilosis, Acinetobacter Lwoffii, Pseudomonas aeruginosa, Enterobacter cloacae. Conclusion The main microbiology of intravascular catheter related infections are bacteria and fungi. Among them, Gram positive coccus and Gram negative bacillus are dominating.