1085例深静脉导管的病原学分析

Descriptive Analysis on the Organisms of 1 085 Deep-venous Catheter Tips Culture

目的 研究深静脉导管送检标本的病原学特征及细菌耐药性,为临床预防和治疗深静脉导管相关性感染提供参考依据.方法 回顾分析2005年1月～2008年12月期间送检的1 085例深静脉导管标本的病原学结果及细菌耐药性.结果 1 085份标本中,临床确诊发生深静脉导管相关感染的阳性标本281份（25.90%）,检出病原菌284株,G^＋菌、G^-菌和真菌分别占50.71%,17.25%和32.04%.最常见的病原菌是表皮葡萄球菌（22.89%）、金黄色葡萄球菌（15.14%）、白色念珠菌（12.68%）和鲍曼不动杆菌（7.39%）.凝固酶阴性葡萄球菌中MRScn占83.69%,金黄色葡萄球菌中MRSA占90.70%.葡萄球菌和肠球菌对万古霉素100%敏感,对青霉素100%耐药;鲍曼不动杆菌的耐药性呈现逐年上升趋势,并且有全耐药菌株出现.结论 发生深静脉导管相关性感染的病原菌多以耐药菌株为主,且病原菌的耐药性呈现出逐年上升趋势;故加强病原学监测,规范导管操作及护理,是控制深静脉导管相关性感染发生的关键.

Objective To afford a referent method for the clinical prevention and treatment of the catheter-related infectious diseases. To investigate the characteristics of the organisms of deep-venous catheter（DVC） tip culture and their antibiotics resistance. Methods The culture results of 1 085 DVC tip were analysed retrospectively from year 2005 to 2008. Results Among 1 085 catheter tip cuhures,281 （25.90%） were positive with 284 microorganisms： G^＋ bacteria accounted for 50.71% ,G^- bacteria 17.25% and fungus 32.04%. The four most common microorganisms were Staphylococcus epidermidis （22. 890/00 ） ,Staphylococcus aureus （15.14 %） ,C. albicans（12. 68% ） and Acinetobacter baumanii （ 7. 39 % ） respectively. 83.69% of Staphylococcus epidermidis were MRScn, 90. 70% of Staphylococcus aureus were MRSA. The Staphylococcus and Enterocoecus were 100% sensitive for vancomycin,but 100% resistant for penicillin. The Acinetobacter baumanii had an increasing tendency in drug-resistance rate and some of them were multiple drug-resistant. Conclusions The most common pathogens cultured from the DVC were drug-resistant and drug-resistant had an increasing tendency. It＇s key to en- force the etiological monitor and the medical attendance of catheters and to prevent cross infection for controlling the catheter-related infection.