重症监护病房导管相关性感染的危险因素及病原学研究

Research on risk factors and pathogenic characteristics of catheter-related infection in intensivecare unit

目的探讨重症监护病房（Icu）导管相关性感染（CRI）的危险因素及病原学特点，以指导临床治疗。方法对2007年1月至2010年12月送检的247例深静脉导管（DVC）标本的培养情况进行回顾性分析。结果247例DVC标本中，阳性结果41例患者作为确诊CRI，阴性结果206例患者作为未确诊CRI；与未确诊CRI患者比较，发现CRI与患者有无感染性疾病、导管留置时间及穿刺部位有关（P〈0．05）；CRI病原菌以革兰阳性菌为主（58．5％，24141），其中表皮葡萄球菌为主要致病菌（22．O％，9／41），绝大多数病原菌出现严重耐药。结论CRI的发生与多种因素有关，其病原菌以革兰阳性菌为主，对于留置DVC患者应加强病原学的监测。

Objective To investigate the risk factors and pathogenic characteristics of catheter- related infection （CRI） in intensive care unit （ICU）,so as to find a better way for its treatment. Methods Retrospective analysis was performed on 247 deep-venous catheter （DVC） from January 2007 to December 2010. Results Among 247 patients,positive results of 41 patients diagnosed CRI,negative results of 206 patients undiagnosed CRI. Compared with undiagnosed CRI patients, found the correlation of the underlying infectious diseases, indwelling time of catheter and puncture sites associated with CRI occurred （P 〈 0.05）. CRI major pathogen was gram-positive bacteria （58.5%, 24/41 ）, in which Staphylococcus epidermis was the major pathogenic bacteria （22.0% ,9/41）. The drug resistance occurred in most pathogen. Conclusions The occurrence of CRI is related with multiple clinical factors. The gram-positive bacteria is the major pathogen. The etiological monitor should be enforced in patients with DVC.