ICU病房中心静脉导管相关性感染分析研究

Pathogen culturing in ICU of the catheter related infection

目的研究在ICU内中心静脉导管相关感染(CRI)、导管相关性菌血症(CRB)的发生率及CRI的危险因素,为降低CRI、CRB的发病率提供有益的参考。方法随机选取2004年1月～2009年12月在我院ICU中的300例患者留置的中心静脉导管进行尖端细菌培养,同时进行血培养。结果 300例中35例(11.7%)发生CRI,CRB5例(1.7%)。病原菌菌群分布:革兰阳性球菌占54.3%,革兰阴性杆菌占34.3%,真菌占11.4%。前5位致病菌依次为表皮葡萄球菌、金黄色葡萄球菌、肺炎克雷白杆菌、铜绿假单胞杆茵、白色念珠菌。CRI、CRB的危险因素包括原发病种类、穿刺置管部位、中心静脉导管留置时间等。结论 CRI、CRB是留置中心静脉导管最严重的并发症。早期诊断、及时合理应用抗生素对降低发病率及病死率具有重要的意义。

Objective To investigate the pathogen culturing in ICU of the catheter related infection（CRI）,catheter related bloodstream infection（CRB）and risk factors of cardiovascular surgery in order to provide the beneficial reference.Methods From January 2004 to December 2009,a total of 300 cases were determined,and the cusp of the catheters was determined by bacterial cultivation and blood bacteria cultivation.Results The infection happened in 35 of 300 patients with inserted central venous catheter.The cusps of CRI rate was 11.7%,CRB rate was 1.7%,54.3% pathogens were gram-positive cocci,43.3% were gram-negative bacilli,11.4% were fungi.The most common strain were Staphylococcus epidermis,Staphylococcus sureus,Klebsiella pneumoniae.Conclusion CRI and CRB are the most severe complication of central venous catheter（CVC）,and it is important to cut down the death with the early diagnosis and applying antibiotics rationally.